title: Oral candidiasis in systemic lupus erythematosus.
abstract: OBJECTIVE
  We assessed the frequency of oral candidiasis and the association between demographic variables, disease-related variables, corticosteroid treatment, other treatments and the occurrence of oral candidiasis in the Hopkins Lupus Cohort.
  
  
  METHODS
  In this large prospective cohort study of 2258 patients with systemic lupus erythematosus (SLE), demographic and clinical associates of oral candidiasis were estimated by univariate, multivariate and within-person regression models.
  
  
  RESULTS
  There were 53,548 cohort visits. Oral candidiasis was diagnosed at 675 visits (1.25%) in 325 (14%) of the patients. In the multivariate analyses, oral candidiasis was associated with African-American ethnicity, SELENA-SLEDAI disease activity, high white blood cell count, a history of bacterial infection, prednisone use and immunosuppressive use. The urine protein by urine dip stick was higher in SLE patients with oral candidiasis. Considering only patients who had candidiasis at some visits in a 'within-person' analysis, candidiasis was more frequent in visits with higher SELENA-SLEDAI disease activity, high white blood cell count, proteinuria by urine dip stick, a history of bacterial infection and prednisone use. The use of hydroxychloroquine was associated with a lower risk of oral candidiasis, but was not statistically significant (p = 0.50) in the within-person analysis models.
  
  
  CONCLUSIONS
  This study identified multiple risk factors for oral candidiasis in SLE. Inspection of the oral cavity for signs of oral candidiasis is recommended especially in SLE patients with active disease, proteinuria, high white blood cell count, taking prednisone, immunosuppressive drugs or antibiotics.
authors.affiliation: Johns Hopkins University, School of Medicine Division of Rheumatology, Baltimore, MD, USA.
authors.forename: M
authors.initials: M
authors.lastname: Fangtham
authors.affiliation: University of Maryland Department of Epidemiology and Public Health, Baltimore, MD, USA.
authors.forename: L S
authors.initials: LS
authors.lastname: Magder
authors.affiliation: Johns Hopkins University, School of Medicine Division of Rheumatology, Baltimore, MD, USA mpetri@jhmi.edu.
authors.forename: M A
authors.initials: MA
authors.lastname: Petri
mesh_terms: D000328:Adult; D002180:Candidiasis, Oral / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
keywords: Oral candidiasis; oral thrush; systemic lupus erythematosus