Candidiasis: Red and White Manifestations in the Oral Cavity

Abstract

Candidiasis is a very common malady in the head neck region. This review will concentrate on intraoral, pharyngeal and perioral manifestations and treatment. A history of the origins associated with candidiasis will be introduced. In addition, oral conditions associated with candidiasis will be mentioned and considered. The various forms of oral and maxillofacial candidiasis will be reviewed to include pseudomembranous, acute, chronic, median rhomboid glossitis, perioral dermatitis, and angular cheilitis. At the end of this review the clinician will be better able to diagnose and especially treat candidal overgrowth of the oral facial region. Of particular interest to the clinician are the various treatment modalities with appropriate considerations for side effects.

Oral Candidiasis: A Disease of Opportunity

“…Oral candidiasis (OC), commonly referred to as "thrush" encompasses infections of the tongue and other oral mucosal sites and is characterized by fungal overgrowth and invasion of superficial tissues [1][2][3]. The colloquial term "thrush" refers to the resemblance of the white flecks present in some forms of candidiasis with the breast of the bird of the same name.…”

“…Acute pseudomembranous candidiasis, often referred to as "thrush", usually presents as multifocal curdy yellow-white plaques throughout the oral mucosa ( Figures 1A,B). A diagnostic feature of this infection is that these plaques, consisting of desquamated epithelial and immune cells together with yeast and hyphae, can be removed by gentle scraping, leaving behind an underlying red erosive base [1,3,14]. The diagnosis of pseudomembranous candidiasis is essentially a clinical diagnosis based on the presence of distinctive clinical features.…”

Sensitivity to antifungals by Candida spp samples isolated from cases of chronic atrophic candidiasis (CAC)

“…Candidiasis is often associated with local conditions, such as other oral lesions (traumatic fibromas, aphthous stomatitis, carcinoma, etc. ), or systemic diseases, such as diabetes, cardiovascular disorders, depression, and immunosuppression (Lund et al, 2010;Brandolt et al, 2017;Hellstein & Marek, 2019). In the present study, most patients had no systemic diseases or other oral lesions.…”

“…Yeasts of the species C. albicans account for 80-90% of all cases of CAC, although other species can also be implicated, such as C. tropicalis, C. parapsilosis, C. glabrata, C. stellatoidea, C. guilliermondii, and C. krusei (Lund et al, 2010;Costa et al, 2013;Alam et al, 2014;Hellstein & Marek, 2019;Punnia-Moorthy, 2019). In the present study, more than 90% of isolates were identified as C. albicans, either as the sole species identified or as one of the species involved.…”

“…Among the several clinical forms of candidiasis, CAC is considered one of the most ubiquitous of all opportunistic infections, frequently co-occurring with angular cheilitis, at the labial commissures, or in the "kissing lesion" of the dorsum of the tongue (Rao, 2012;Chambo-Filho et al, 2014;Brandolt et al, 2017;Hellstein & Marek, 2019). Studies suggest that women are more affected than men; however, it is known that women are more likely to seek medical attention and that incidence increases with advancing age, i.e., older adults have a higher prevalence of this condition, particularly due to denture use and difficulties in oral hygiene (Rao, 2012;Chambo-Filho et al, 2014).…”