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Definition

Chronic mucocutaneous candidiasis is a heterogeneous disorder of the immune system characterized by persistent candida (yeast) infections of the mucous membranes, scalp, skin and nails. The infection involves the very outer-most layers of the skin. Healthy skin is quite resistant to candidal infection and in essentially all cases a predisposing factor is present.
It may be associated with:

  • An abnormal gene from one parent or an abnormal gene is inherited from each parent.
  • Endocrine conditions e.g. hypoparathyroidism, hypothyroidism, hypoadrenalism and diabetes mellitus.
  • Immune defects i.e. malfunctioning T-lymphocytes, low levels of immunoglobulin.

Rarely, chronic mucocutaneous candidiasis develops in adult life. This is often as a result of a thymoma (tumor of the thymus gland) and is associated with internal diseases such as myasthenia gravis, myositis, aplastic anaemia, neutropaenia and hypogammaglobulinaemia.

Causes

In case of chronic mucocutaneous candidiasis, the body is less able to fight fungal infections, including yeast infections. These disorders may be confined to the cutaneous surface, with little propensity for systemic involvement.

Symptoms

The fungus may cause mouth infections (thrush) as well as infections of the scalp; skin; nails; and membranes lining the mouth, eyes, digestive tract, and reproductive tract. Severity varies: The disorder may affect one nail or cause a disfiguring rash that covers the face and scalp.

Treatment

Nearly seventy-five percent of all women will suffer at least one episode of candida or vaginal thrush during their lifetime. Most of these women experience infrequent attacks and respond well to drug therapy; however in some cases the infection is persistent and is resistant to most candida treatment options.

The yeast Candida albicans causes Ninety-five percent of genital candidiasis with the remaining five percent being caused by the yeast Candida glabrata; infections with Candida glabrata, symptoms tend to be milder. Candida albicans has been isolated from vaginal swabs in women who do not complain of symptoms and who do not have clinical signs of disease. This suggests that some change in the vaginal environment needs to occur for the yeast to cause disease. These factors are unknown, but vaginal candidiasis is associated with pregnancy, diabetes and antibiotic treatment.

Usually, the infections may be treated with an antifungal drug- nystatin (mycostatin, nilstat) or clotrimazole (lotrimi, mycelex)-applied to the skin. The primary contributing factor is the use of oral antibiotics (esp. tetracycline).

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