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Mucocutaneous Candidiasis

more about Mucocutaneous Candidiasis


MC


  • Mucocutaneous Candidiasis (MC) refers to a condition caused by a fungus from the candida family (lives on the surface of skin) that develops a diffuse and persistent type of infection of the mouth, nails, skin, and at times other organs.
  • MC, which affects infants (starts before age 3) and young adults, is rarely seen in adults with other diseases.

  • Oral Thrush -- mouth, tongue, and throat are covered with a cream/white-colored, curdlike film (plaques or lesions) or even ulcers (open areas)
  • Thrush lesions may also be seen in the esophagus (the tube that connects the mouth to the stomach), causing pain and difficulty swallowing.
  • Candida can also form lesions on the larynx (vocal cord), causing hoarse voice.
  • Fingernails and toenails have a painful, reddened, and tense swelling at the base or along the sides.
  • Candida infection may also be seen under the nails as a greenish/brown lesion.
  • Reddened, irritated areas (candida tends to grow in moist and warm surfaces) are seen under the arms, groin, breasts, vagina, and in between the buttocks.  These areas are often itchy and uncomfortable.
  • Granulomas (hard and hornlike) lesions with a reddened base are seen on the skin, scalp, and trunk, but rarely on the face, hands, or feet.
  • In very rare occasions, there may be spillage of infection to deeper organs or in the blood.
  • Symptoms of diseases such as Hypothyroidism, hypoparathyroidism, Addison's Disease, pernious anemia, and Diabetes Mellitus may be seen.
  • Liver problems such as hepatitis and Cirrhosis are rarely present.

  • Immune system failure -- the immune system is made up of white blood cells (T and B lymphocytes and others) that use Proteins called immunoglobulins (Ig) to protect the body against infection (from fungi, bacteria, viruses, and parasites), cancer, and toxins (poison).
  • These failures include:
    1. T-lymphocyte abnormality and low levels of Ig
    2. Autoimmune disorders in which the immune cells turn against the normal cells of the body.
    3. Genetics (inheriting defective genes) -- autosomal dominant (abnormal gene from one parent) or autosomal recessive (an abnormal gene from each parent) may play a role in MC.

  • On the basis of clinical history and appearance of lesions
  • Candida can be seen under a microscope after the lesions are swabbed or scraped and the material stained with a dye (Potassium hydroxide).
  • Blood samples may be needed to access the number or function of white blood cells, liver function, and hormonal abnormalities (thyroid, parathyroid, and adrenal hormones).
  • At times, genetic studies may be needed.
  • If the esophagus is infected, a specialist may need to perform an endoscopy (look inside esophagus with a tubelike camera) and take samples for analysis.
  • A chest X-Ray is done to see if the lungs are free of disease.
  • The liver may be examined using an Ultrasound if liver disease is suspected.

  • Adults with thymus gland disorders (where T lymphocytes live), tumors, and other immune disorders such as Myasthenia Gravis, myositis, Aplastic Anemia, neutropenia, hypogammaglobulinemia, AIDS, and cancer.
  • Adults who are on potent medications (long term antibiotics or chemotherapy)

  • The standard treatment consists of anti-fungal medication (prescription).
  • Before starting medication, it is good idea for women to make sure that they are not pregnant.
  • Clotrimazole troches (candy) or Nystatin solution is helpful in oral Thrush.
  • For severe MC, Fluconazole, Ketocoazole, and Azole may be used daily (pills or liquid) and often, for long periods of time.
  • Topical creams (Nystatin) or vaginal preparations (Trimazole) can be helpful if the rash is mild.  If there is pain or itching, topical creams such as corticosteroid or antihistamine creams can help.
  • Experimental treatments such as bone marrow and fetal thymus transplants, as well as Thymosin and Lymphocyte infusion are currently being studied.
  • Rest, limiting your sugar intake, and drink plenty of fluids.
  • Ask your doctor for supplements such as vitamin C, vitamin A, beta-carotene, zinc, thymus extract, and bioflavinoids that strengthen the immune system.

  • Discuss it with your physician. There are reliable treatments available to patients with MC.




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