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Chronic mucocutaneous candidiasis
🍄 Chronic Mucocutaneous Candidiasis (CMC) = persistent/recurrent Candida infections of skin, nails, and mucous membranes due to defective T-cell immunity.
ℹ️ About
- 📌 CMC is a group of disorders where recurrent Candida infections affect skin, nails, and mucosal surfaces.
- 🧪 Underlying problem: T cell dysfunction ➝ impaired immunity against Candida.
🧬 Aetiology
- 🔧 Multiple causes of defective T-cell mediated immunity.
- 🧬 Genetic mutations (e.g., STAT1, IL-17 pathway defects).
- ⚠️ Associated with syndromes such as APECED (Autoimmune Polyendocrinopathy–Candidiasis–Ectodermal Dystrophy).
- May occur with other autoimmune disorders or immunodeficiencies.
🩺 Clinical Features
- ♻️ Recurrent or chronic superficial Candida infections.
- 👄 Oral thrush (persistent white plaques in mouth/esophagus).
- 💅 Chronic nail candidiasis.
- 🍑 Genital candidiasis (recurrent vulvovaginal or balanitis).
- 📌 Infections confined to skin & mucosa ➝ ❌ do not usually progress to disseminated candidiasis.
🔎 Differentials
- 🧬 Other primary immunodeficiencies ➝ SCID, Hyper IgE syndrome.
- 🦠 Secondary causes ➝ HIV, immunosuppressive therapy.
🧪 Investigations
- 🧴 Candidal antigen skin test: shows anergy (failure of immune response).
- 🧬 Genetic testing: useful for familial/syndromic CMC (STAT1, AIRE, IL-17 axis genes).
- 🧫 Fungal culture may confirm Candida species.
💊 Management
- 💊 Antifungal therapy: topical or systemic (fluconazole, itraconazole) for recurrent episodes.
- 🛡️ Immunotherapy: immunomodulation (e.g., IFN-γ in some cases).
- 📈 Monitor for secondary infections and associated autoimmune diseases.
- 👥 Multidisciplinary follow-up: immunology, dermatology, infectious diseases.
📚 References
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