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Chronic mucocutaneous candidiasis
๐ Chronic Mucocutaneous Candidiasis (CMC) = persistent/recurrent Candida infections of skin, nails, and mucous membranes due to defective T-cell immunity.
โน๏ธ About
- ๐ CMC is a group of disorders where recurrent Candida infections affect skin, nails, and mucosal surfaces.
- ๐งช Underlying problem: T cell dysfunction โ impaired immunity against Candida.
๐งฌ Aetiology
- ๐ง Multiple causes of defective T-cell mediated immunity.
- ๐งฌ Genetic mutations (e.g., STAT1, IL-17 pathway defects).
- โ ๏ธ Associated with syndromes such as APECED (Autoimmune PolyendocrinopathyโCandidiasisโEctodermal Dystrophy).
- May occur with other autoimmune disorders or immunodeficiencies.
๐ฉบ Clinical Features
- โป๏ธ Recurrent or chronic superficial Candida infections.
- ๐ Oral thrush (persistent white plaques in mouth/esophagus).
- ๐ Chronic nail candidiasis.
- ๐ Genital candidiasis (recurrent vulvovaginal or balanitis).
- ๐ Infections confined to skin & mucosa โ โ do not usually progress to disseminated candidiasis.
๐ Differentials
- ๐งฌ Other primary immunodeficiencies โ SCID, Hyper IgE syndrome.
- ๐ฆ Secondary causes โ HIV, immunosuppressive therapy.
๐งช Investigations
- ๐งด Candidal antigen skin test: shows anergy (failure of immune response).
- ๐งฌ Genetic testing: useful for familial/syndromic CMC (STAT1, AIRE, IL-17 axis genes).
- ๐งซ Fungal culture may confirm Candida species.
๐ Management
- ๐ Antifungal therapy: topical or systemic (fluconazole, itraconazole) for recurrent episodes.
- ๐ก๏ธ Immunotherapy: immunomodulation (e.g., IFN-ฮณ in some cases).
- ๐ Monitor for secondary infections and associated autoimmune diseases.
- ๐ฅ Multidisciplinary follow-up: immunology, dermatology, infectious diseases.
๐ References
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