Conditions Caused By Candida

1. Oral
2. Intertrigo (inflammatory skin disease involving body folds)
3. Vulvovaginitis
4. Diaper rashes
5. Paronychia
6. Chronic Mucocutaneous Candidiasis

1) Oral Candida

- also known as oral thrush.

• Commonly seen in the first year of life on the inner cheeks and along the gums and roof of the mouth.
• Cream-coloured crumbling curd-like white patches, which can be easily removed by scraping off the surface, leaving a red base.
• May cause some ulceration and erosion in those who are immunosuppressed.
• May extend down the throat into the pharynx and esophagus.
• May be seen in combination with herpes, and is more common in those who are neutropenic (blood disorder) or who have AIDS.

a) Acute Atrophic Candidiasis - patients usually complain of soreness in the mouth.

• May show as a smooth patch of skin on the tongue. Most commonly seen after the use of oral antibiotics or HIV infection.

b) Leukoplakia - this will be a persistent, firm, irregular, white patch particularly seen on the cheek and tongue.

• Leaves a slightly sore, roughened, surface
• More common in men who are middle aged.
• Increased risk if you smoke or have a condition called Chronic Mucocutaneous Candidiasis (skin and mucous involvement).

c) Angular Cheilitis - this is seen in the corners of the mouth with redness.

• Affected area is often sore, usually caused by a fold of skin at the corners of the mouth retaining moisture.
• More common if you have had dental work or wear dentures.

2) Intertrigo

- this occurs in the flexures or folds of the skin.

• Usually seen in those who are overweight.
• There is redness and moisture in the skin fold.
• Small pustules (round raised area of inflamed skin filled with pus) or papules (a protuberance) that situate around the main area of redness.
• You may experience peeling, itching and soreness
• Can be confused with seborrheic dermatitis, psoriasis, Hailey-Hailey, or Darier's disease.

3) Vulvovaginitis

- vaginal yeast or thrush is common.

• Usually soreness and itching, with a thick, cream or white discharge.
• There is pain on intercourse.
• In some individuals there may be just redness. Rashes can sometimes extend on to the groin area.
• Common with pregnancy and increases in frequency in those using the birth control pill.
• When condition is chronic the skin may have a thin glazed atrophic appearance.
• In men, there is inflammation of the head of the penis (balanitis), and often small red papules or sometimes pustules.
• · Commonly flares after sexual activity, with some soreness and signs and symptoms can occur intermittently.

4) Diaper Candidiasis

- sometimes seen in babies who have diaper rashes; however, not all diaper rashes are caused by Candida.

• When Candida is present there are often small fragile pustules. These pustules are often dry and peel, leaving a scaling on the fringe. This produces small satellites around the main area of the rash.
• There is a rare condition called acrodermatitis enteropathica. This is secondary to zinc deficiency. This should always be considered when a diagnosis of diaper Candida is made. Occasionally there is a condition called nodular granulomatous Candida. It is also called granulomatous gluteale infantum. This is seen as firm reddish nodules that may be as large as 1-2cm, and is normally seen on the vulva and buttocks. There may not be much else to see on the skin and it may occur after the majority of the rash has cleared. Most of the time this will clear spontaneously over time.

5) Paronychia

- this Candida infection around the nails is usually seen in those who have their hands in water or in those who are in contact with and handle food.

• Common in pastry chefs as food or organic debris encourages the yeasts to grow.
• The area around the nail is usually red and swollen and the cuticle has disappeared.
• There is sometimes a pustular discharge and the site will be tender. In time the nail will discolour and will lift off the nail base and produce what is called lateral onycholysis.

6) Chronic Mucocutaneous Candidiasis

- this is a persistent Candida infection, that is unresponsive to medical treatment.

• Appears in the mouth and the skin.
• Usually starts during infancy or childhood. May be accompanied with a persistent oral thrush, which sometimes can be hypertrophic, (increase in size) or it can produce thickened plaques in the mouth.
• Others will present with an intertrigo flexural persistent Candida infection (inflamed skin surfaces)There are some who will show chronic paronychia with redness around the nail folds.
• This is a genetic condition, that can be either recessive or dominant. It can also be secondary to a number of endocrine disorders such as hypothyroidism or hypoparathyroidism.
• There is also a late onset variant that is seen in individuals with connective tissue disease such as systemic lupus.
• The immunological defects are usually seen in those who have white cells that are unable to phagocytose (kill) yeasts.
• The defects will be seen in polymorphs (immune system) and macrophage (healing) function. There is usually a deficiency in the enzyme found in white blood cells (myeloperoxidase).