Chronic mucocutaneous candidiasis

Chronic mucocutaneous candidiasis: a case with exuberant cutaneous horns in nipples

Chronic mucocutaneous candidiasis is a rare disorder characterized by persistent and recurrent infections by Candida due to changes in cellular immunity and may be associated with autoimmune endocrine disorders. It is refractory to the usual antifungal treatments, which merely control it with imidazole derivatives. This reports the case of a 50-year-old female patient who referred vaginal discharge associated with vulvar ulcerated lesions and whitish plaques on oral and genital mucous membranes of onset in adolescence besides cutaneous horns in nipples. The clinical picture, family history, culture and anatomopathological studies were consistent with chronic infection by candida. Treatment with systemic antifungals obtained partial response of lesions characterizing a clinical picture of Chronic Mucocutaneous Candidiasis.

Juvenile juxtavermilion candidiasis: yet another form of an old disease?

Five cases of a chronic, self-limiting Candida albicans infection of the lip vermilion and juxtavermilion skin in young persons are presented. These infections typically appeared as erythematous, pruritic, yellow crusting plaques of the juxtavermilion skin, with or without desquamation of vermilion surfaces. Evidence of intraoral candidiasis, especially loss of filiform lingual papillae, was present in several cases. The disorder mimics the early stage of chronic mucocutaneous candidiasis but remains within a few millimeters of the mucocutaneous junction and affected individuals appear (with a possible exception) to be immune competent. Mild trauma apparently triggers the infection. The authors emphasize that a scientifically sound cause-and-effect relationship between this new disease and Candida albicans is not herein established and present these cases in the hope that others will thereby be identified and a firmer causal relationship be established.

Host-parasite relationship in opportunistic mycoses

Aspergillosis and mucormycosis are opportunistic fungal infections that share several unique features. The etiologic agents of aspergillosis and mucormycosis are ubiquitous in the environment, but are opportunistic organisms and usually infect only patients predisposed by some underlying disease or treatment. These infections are typically characterized by hyphal tissue invasion and a predilection of the organism for blood vessel invasion with hemorrhage, necrosis, and infarction. Also, these organisms are not dimorphic, like the true pathogenic dimorphic fungi, as they grow both in the environment and within the host in hyphal forms. However, the host must contend with several forms to successfully eliminate them. Each form displays different antigenic and surface features and elicits different host responses. Finally, if germination and hyphal growth occur, the host must compete with a rapidly growing organism that is too large to be ingested by a single cell and so must be handled by extracellular defense mechanisms.