Candidiasis

Synonym(s)

Moniliasis; candidosis; thrush

Fissures Corner Mouth
Candidiasis. Red, fissured plaque at the corner of the mouth

Definition

Skin and mucous membrane infections caused by Candida species

Pathogenesis

Warm, moist parts of the body susceptible to infection; host factors such as oral hygiene important in intraoral infection (thrush); primary immune defects in muco-cutaneous candidiasis; endocrinopathies such as diabetes mellitus, Cushing's syndrome, Addison's disease, hypoparathy-roidism associated with recurrent infections

Clinical manifestation

Thrush: discrete or confluent white plaques on oral mucosa common on the tongue; erythema and fissures at the corners of the mouth

Candida intertrigo: red macerated intertrig-inous areas with satellite pustules Vulvovaginitis: pruritic, white, cheesy discharge; beefy red vulva Chronic mucocutaneous variant: white adherent plaques of thrush or the angular cheilitis of perleche; oral involvement may extend to the esophagus; nails are thickened, fragmented, and discolored, with significant edema and erythema of the surrounding periungual tissue; skin lesions often are acral or in the scalp, with ery-thematous, hyperkeratotic, serpiginous plaques

Interdigital involvement (erosio interdigitalis blastomycetica): erythema, scale, and satellite papules and pustules, most commonly in the space between the long finger and ring finger

Differential diagnosis

Thrush: Fordyce spots; hairy leukoplakia; lichen planus; aphthous stomatitis; pemphigus vulgaris; herpes simplex virus infection Candida intertrigo : tinea cruris; contact dermatitis; seborrheic dermatitis Inverse psoriasis mucocutaneous variant: acrodermatitis enteropathica; immunodeficiency diseases such as HIV infection, DiGeorge syndrome, Nezelof syndrome or

Cantharidin 115

severe combined immunodeficiency; nutritional deficiency

Therapy

Thrush: clotrimazole 10 mg troche taken 3 times daily for 7-10 days; fluconazole; itra-conazole

Candida intertrigo: fluconazole; azole antifungal agents; Zeasorb AF powder used twice daily as prophylaxis Mucocutaneous variant: fluconazole; clot-rimazole 10 mg troche taken 3 times daily for 7-10 days; cimetidine 400 mg PO 4 times daily indefinitely

References

Zuber TJ, Baddam K (2001) Superficial fungal infection of the skin. Where and how it appears help determine therapy. Postgraduate Medicine 109(1):117-120,123-126,131-132

References

Tobin DJ, Paus R (2001) Graying: gerontobiology of the hair follicle pigmentary unit. Experimental Gerontology 36(1^29-54

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