Candidiasis describes a group of fungal infections involving the skin and mucous membranes. Infection is caused by Candida species, primarily Candida albicans.
C albicans is a dimorphic fungus that can asymptomatically colonize the oral or genital mucosae in healthy individuals.
Oral colonization is estimated in 50% of healthy adults,
while genital colonization is seen in 21% of women.
When the local ecology is disturbed, or where there is an immune defect, Candida overgrowth may lead to an opportunistic infection. The mucosal surfaces primarily affected by candidiasis are the oral cavity, esophagus, angles of the mouth, and genitals (causing vulvovaginitis in females, balanitis in males).
Oral candidiasis may present as either white or erythematous lesions and either an acute or chronic infection.
Thus, the presentations can be divided into the following four subtypes:
Acute pseudomembranous candidiasis (thrush): The classic multiple white-flecks on the tongue, buccal mucosa, and palate
Chronic hyperplastic candidiasis: Thick white plaques on the buccal mucosa and labial commissures
Acute atrophic (erythematous) candidiasis: Erythematous patches on the palate
Chronic atrophic candidiasis (denture stomatitis): A form of erythematous candidiasis, resulting from poorly fitted dentures causing a burning, sore mouth
There are also conditions that may predispose individuals to chronic, multifocal infections from Candida. This can lead to syndromes such as chronic mucocutaneous candidiasis (CMC).