I enjoyed the pearl about using an alcohol sanitizer for yeast in skinfolds [Advisor Forum, October 2016]. If the area is red, Selsun blue as a body wash will not sting, and drying with a hair dryer works well.—Susan Smith, PhD, FNP, Albuquerque, N. Mex. (217-1)

I also encounter many patients who get yeast infections in skinfolds. I have the patients apply a solid antiperspirant/deodorant in the skinfold, once the skin is healed from the yeast rash. It works very well in preventing further yeast infections.—Ursula Fuller, FNP, BC, Osceola, Mo. (217-2)

When treating tinea pedis, I often prescribe econazole cream (or any generic azole cream); apply BID until clear, may repeat as needed, dispense 80 grams or 160 grams (if the patient has large feet), and it may be refilled 11 times. Patients with a chronic disease for which we have no cure do better if you give them enough treatment so they do not keep running out. A-15 gram tube of clotrimazole cream is barely enough to cover 2 large feet for more than a week.

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Also, once the tinea pedis on the soles is clear, I recommend that patients spray some type of antifungal spray BID or at least daily to their 10 toes/between the webspaces. The spray helps to keep the webspaces dry and reduces the maceration/breakdown that often occurs. If the soles of the feet are getting itchy/scaly and it looks like the tinea pedis has recurred, then start up again with the econazole cream BID until clear.—Christy Flory, RN, MS, NP, Annapolis, Md. (217-3)

These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.