CANDIDIASIS

CANDIDIASIS

1. Angular chelitis

   • clinical features
     • Erythema, fissuring, and scaling of the angles of the mouth
   • we can found both Bactria and fungal
   • Often occurs alone but can be found as part of chronic multifocal candidiasis.
   • Predisposing factors
     • Reduced vertical dimension of occlusion
     • Continuous wetting and saliva pooling of the corners of the mouth.
   • 60 % combined infection
     • C. Albicansand & staphylococcus aureus
   • treatment
     • antifungal(topical at the beginning)

2. Pseudomembranous candidiasis (thrush)

   • clinical features
     • white plaques
     • palat or buccal mucosa
     • displaque (removable)
     • Underlying mucosa may appear normal or erythematous (no bleeding after remove this plaque).
   • under microscope
     • Hyphae, yeasts, desquamated epithelial cells, and debris
   • causes
     • Broad spectrum antibiotics (acute)
     • Impairment of the patient’s immune system (chronic)
   • symptoms
     • Burning sensation
     • Unpleasant taste (salty or bitter)

3. Chronic multifocal candidiasis

   • areas
     • Dorsal tongue
       • (type erythematous or atrophic)
     • junction of the hard and soft palate
       • Pseudomembranous
     • angles of the mouthe
       • sth like chelitis
     • In the palate where the tongue is at rest (kissing lesion).

4. Chronic hyperplastic candidiasis (candidal leukoplakia)

   • hyperplasia in epithelium
     • I cant remove the white membrane under lining mucosa because all epithelium surface is hyperplastic
   • smokers
   • Clinical Features
     • Usually located on the anterior buccal mucosa
     • Cannot clinically be distinguished from a routine leukoplakia
     • White patch that cannot be removed by scraping.
   • The least common form of candidiasis
   • diagnosis
     • we give the pt s 14-10 for antifungal topical, if he gets better his disease is Chronic Hyperplastic Candidiasis , if not , we will take biopsy
       • complete resolution of the lesion after antifungal
     • The presence of candida hyphae associated with the lesion and, more importantly
     • White patch that cannot be removed by scraping
     • Cannot clinically be distinguished from a routine leukoplakia
     • for distinguishing candidal hyphae from other fungae
       • invading the surface of the Epithelium + complete resolution of the lesion after antifungal therapy
   • thick, white plaques,that typically do not rub off

5. Acute atrophic candidiasis

   • more common than thrush
   • burning sensation
   • loss of filiform papillae of the dorsal tongue
   • erythromatous candidiasis
     • chronic
       • asymptomatic
     • thickness of epithelium reduced
       • will show mucosa reddish in color

6. Mucotaneous candidiasis

   • Severe oral candidiasis
   • involved mucous membrane and skin together
   • May also be seen as a component of a relatively rare group of immunologic disorders
     • The severity of the candidal infection correlates with the severity of the immunologic defect.
     • Immune problem usually becomes evident during the first few years of life, when the patient begins to have candida infections of the mouth, nails, skin, and other mucosal surfaces.

7. Central papillary atrophy (median rhomboid)

   • Posterior dorsal tongue
     • Midline, well demarcated erythematous zone (loss of the filiform papillae "depapillated erythematous area ").
   • Asymptomatic
   • treatment
     • antifungal therapy
   • In patient who has erythematous area they found in the palate where the tongue is resting (direct contact) candidal lesion as Pseudomembranous Candidiasis

8. Denture stomatitis

   • causes
     • poor oral hyegiene
     • allergic to acrylic material
     • the denture doesn't fit properly
     • Inadequate curing of the denture acrylic
   • Erythema +/ petechial hemorrhage
   • Localized to the denture bearing areas of a maxillary removable dental prosthesis
   • Usually asymptomatic
   • Predisposing factors
     • Usually the patient admits to wearing the denture continuously
   • Etiology
     • Tissue response by the host to the various microorganisms living beneath or real infection by microorganism
       • Biopsy specimens of denture stomatitis seldom(rarely) show Candida hyphae invading keratin layer of the host epithelium
       • The surface of the denture if swabbed, the denture typically shows much heavier colonization by yeast