Mucocutaneous Candidiasis: Its Different Clinical Manifestations And General Treatment
Chronic Paronychia In Mucocutaneous Candidiasis
Mucocutaneous candidiasis is caused mostly by candida albicans, though occasionally other species of Candida may be responsible. This organism is found as a commensal on the skin, oral cavity and the gastrointestinal tract. Under favourable conditions of growth such as excessive moisture and maceration, immune deficiency, diabetes mellitus or treatment with tetracycline or immunosuppressive drugs, this fungus multiplies and causes disease. In its natural habitat, the organism is found in the spore or yeast form but when it invades the skin or the mucous membrane, it grows to form a mycelium and the filaments can be demonstrated microscopically in skin scrapings. The skin, mucous membranes of the mouth and genitalia, base of the nails and the nail plates are affected by this organism.
Trush (Oral Candidiasis) In Mucocutaneous Candidiasis
Clinical Presentations And Treatment
Thrush (Oral candidiasis): The mucous membrane of the mouth may be involved in healthy newborns or in marasmic babies. In the newborn, the infection may be acquired from the infected genital tract of the mother. Greyish white membranous plaques are found on the surface of the mucous membrane. There is diffuse redness and burning sensation in the oral mucosa.
Vulvo-vaginitis: There is severe irritation of the vulva and vagina associated with a thick, creamy white discharge. The mucous membrane is involved. The adjacent skin is smooth, red, and moist with a margin of saddened white epidermis. This type of candida infection is particularly associated with diabetes and is also common in pregnancy.
Chronic Paronychia: When candida involves the skin around the base of the nails, it produces glazed, red, bolster like swellings with loss of cuticle. Occasionally, the organism invades the nail plate, causing dark brown pigmentation at the lateral margins of the nails. Chronic paronychia is an occupational disease of housewives and also in certain industries such as fruit canning in which the hands are constantly in contact with water.
Angular Stomatitis: Proliferative lesions may be seen at the angles of the mouth and lips similar to those seen in vitamin B complex deficiency.
Balanoposthitis: This produces extreme degree of pain, erythema and maceration in the glans penis and prepuce. The contidion is acquired due to sexual contact with infected females.
Intertrigo: This occurs as diffuse erythema and maceration of the folds of the skin associated with severe itching and burning sensation. It is mostly seen in the groin, interdigital spaces of the toes and fingers, under the breast and other folds.
Generalised Cutaneous Candidiasis: Occasionally, the lesions of candidiasis may spread to the entire body resulting in multiple ill-defined erythematous and scaly macules. This type of candidiasis generally occurs in very severely ill patients, particularly those suffering from uncontrolled diabetes or those who are on treatment with immunosuppressive drugs.
The condition responds well to local application of gentian violet (1% acqueous solution) or nystatin or hamycin alone or in combination with steroids applied locally.
© 2014 Funom Theophilus Makama