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Chronic mucocutaneous candidiasis - Causes, Symptoms and Treatment

Definition

Chronic mucocutaneous candidiasis (CMC) is the label given to a group of overlapping syndromes that have in common a clinical pattern of persistent, severe, and diffuse cutaneous candidal infections. These infections affect the skin, nails and mucous membranes.It may be associated with:
Genetic predisposition with autosomal dominant inheritance or autosomal recessive inheritance.
Endocrine conditions e.g. hypoparathyroidism, hypothyroidism, hypoadrenalism, diabetes mellitus.
Immune defects i.e. malfunctioning T-lymphocytes, low levels of immunoglobulin.
Chronic mucocutaneous candidiasis is nearly develops in adult life. This is often as a result of a thymoma 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

Chronic mucocutaneous candidiasis is of varying size and shape and it may be difficult to detect in darker-skinned patients. Primary patches may have adjacent satellite papules and pustules. Perianal candidiasis produces white maceration and pruritus ani. Vulvovaginal candidiasis causes pruritus and discharge .
Subungual infections are characterized by distal separation of one or several fingernails (onycholysis), with white or yellow discoloration of the subungual area.
Chronic mucocutaneous candidiasis is characterized by red, pustular, crusted, and thickened plaques resembling psoriasis, especially on the nose and forehead and invariably associated with chronic oral candidiasis.

Treatment

Nearly seventy-five percent of all women will suffer at least one episode of candida. 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. These factors are unknown, but vaginal candidiasis is associated with pregnancy, diabetes and antibiotic treatment.
Ketoconazole is a promising new agent for treatment of chronic mucocutaneous candidiasis. A course of one or two weeks therapy is given to start with, if the Candida infection recurs quickly.
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).