Cutaneous infection with C. albicans tends to occur in areas that are chronically moist, warm, and macerated. For this reason, Candida is among the most common causes of diaper dermatitis. An early diaper rash in Fig. 6-40 illustrates some of the distinctive features of monilial infection. Note the confluent, glistening, beefy-red erythema, which begins in the perianal skin and spreads by local extension. There are numerous small satellite lesions. If untreated, this rash will go on to involve the gluteal folds, buttocks, and inner thighs. More extensive involvement is seen in Fig. 6-41; note the peripheral scaling and again the satellite lesions. On occasion, these peripheral pustules and papules will involve the entire abdomen and back. Diagnosis of cutaneous candidiasis can be confirmed by potassium hydroxide preparation or by fungal culture. Treatment consists of the use of imidazole creams, such as ketoconazole, or nystatin. The several preparations that also contain a fluorinated topical steroid are not required for this condition and may lead to adverse local side effects.