An elderly female presents with a painful rash under her breasts. The KOH prep reveals pseudohyphae. What treatment should be recommended?

The recommendation for treatment with a topical antifungal and fasting blood glucose is sound due to the presentation of the rash characterized by pseudohyphae found on the KOH prep. The presence of pseudohyphae is indicative of a fungal infection, commonly associated with Candida species. In elderly patients and those with certain risk factors, including obesity, diabetes, or immunocompromised states, Candida infections can occur in intertriginous areas such as under the breasts.

Using a topical antifungal agent, such as clotrimazole or miconazole, is effective in treating localized Candida infections. Additionally, checking the fasting blood glucose is important because it can help identify potential underlying diabetes, a common condition that can predispose individuals to fungal infections. Managing blood glucose levels may also aid in resolving the infection and preventing future occurrences.

Other treatment options do not appropriately target the underlying cause of the rash. Oral steroids could exacerbate a fungal infection rather than help, while an oral antibiotic may not treat a fungal source. High-potency topical corticosteroids could suppress inflammation but not address the fungal infection effectively, potentially worsening the condition. Therefore, the recommended approach of topical antifungal treatment along with assessing blood glucose provides a comprehensive plan to address the current infection and potential