Oral manifestation of chronic mucocutaneous candidiasis: seven case reports.
BACKGROUND
Chronic mucocutaneous candidiasis (CMC) is a rare disorder characterized by persistent or recurrent candidal infections of the skin, nails and mucous membranes or by a variable combination of endocrine failure as well as immunodeficiency. Oral clinicopathological features of CMC have seldom been described in detail.


METHODS
Seven patients with CMC were reported in the study. The clinical and histological findings, etiological Candida species, immunological evaluation, and therapeutic pattern of oral lesions, were analyzed.


RESULTS
Long-standing whitish hyperplastic and nodule-like lesions with exaggerated deep fissure were the typical and characteristic oral manifestations presented by all patients. The tongue was the most common site affected. Histologically, no obvious distinction was found between CMC and other forms of candidal infection. Abnormal proportions of T-lymphocyte subsets and positive titers of autoantibody were observed in three subjects (42.9%) and one patient (14.3%) respectively. Meanwhile, four subjects (57.1%) showed decreased albumin and increased globulin, three cases (42.9%) had high levels of ESR. But no iron deficiency was found. Candida albicans was the microorganism isolated from these patients.


CONCLUSIONS
Multiple and widespread candidal infectious lesions can be observed on the oral cavity of CMC patients. Hyperplastic and nodule-like lesion with irremovable whitish patches and deep fissure are the most common oral manifestations of these patients. Dentists, otolaryngologists and pediatricians should be familiar with the clinical appearances of CMC to make an accurate diagnosis. Potential systemic disorders should be concerned to avoid the reoccurrence of oral candidiasis.
Liu
Xiaosong
X
Department of Oral Medicine, School and Hospital of Stomatology, Peking University, Beijing, China.
Hua
Hong
H
D000328:Adult; D000935:Antifungal Agents / Q000494:pharmacology; D002176:Candida albicans / Q000302:isolation & purification; D002178:Candidiasis, Chronic Mucocutaneous / Q000150:complications*; D002180:Candidiasis, Oral / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology / Q000473:pathology; D002648:Child; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology; D009761:Nystatin / Q000494:pharmacology
D000935:Antifungal Agents; D009761:Nystatin; D015725:Fluconazole