Have you recently observed persistent white plaques in your mouth that seem inseparable from the oral cavity? Have these plaques appeared after wearing dentures? Or perhaps you're an avid baker who frequently washes hands? If you've noticed changes in your nail cuticles or pus around the nail bed, it may be candidiasis, a fungal infection associated with abscess formation.
Candida is a genus that includes more than 150 species, of which a few cause human diseases. A common fungal commensal (typically present organism in the body), Candida albicans can become pathogenic because of predisposing factors that include:
Moisture: Often beginning in the depth of skin folds, like that of the groin area or the armpits, the infection can start as a glazed region of redness, progressing to pustule formation. This is also seen in between fingers and toes.
Water immersion: Prolonged 'wet work' like cooking, baking, and house-cleaning results in the loss of nail cuticles, making the nail fold rolled and red.
Oral contraceptive: Using oral contraceptive pills (OC pills) increases the risk of Candidal vulvovaginitis, marked by itching in the vulva and prominent curdy white vaginal discharge. These pills can cause Candidal balanoposthitis, which occurs after intercourse with a partner suffering from C. Vulvovaginitis. This can also result in the appearance of white scales on the male genitalia.
Broad-spectrum antibiotics: Older adults are especially susceptible to candidiasis if they frequently consume broad-spectrum antibiotics (like metronidazole). White plaques are seen in the oral cavity that are difficult to remove—often observed on the gums, tongue, and palate.
Dentures: Those who wear dentures can develop angular stomatitis, where candida is seen as white plaques at the angle of the mouth. They may also lead to chronic atrophic candidiasis, that causes redness and swelling on the palate.
Comorbidities: Diabetes mellitus is a well-known predisposing factor to candidiasis. It may affect the groin region, inframammary area (below the breast) in women, and between fingers. It is the most common fungal infection seen in people suffering from HIV-AIDS.
Deeply invasive candida infections can have far-reaching consequences that affect various internal organs. These infections can penetrate deeply, leading to kidney and gallbladder infections and impacting nearly every organ in the body. Muscular involvement beneath the skin can cause significant pain, while ocular damage is also possible. The brain, heart, and kidney are frequently affected, followed by the pancreas, skeletal muscles, bones, and meninges, the protective layers covering the brain.
Diagnosis and treatment:
Clinical findings are often used to diagnose the condition, followed by laboratory tests. To visualise the hyphae, which are characteristic of candida, saline and 10 percent potassium hydroxide wet mounts, as well as Gram's stain, are commonly employed.
The treatment for candidiasis includes eliminating predisposing factors, like controlling blood sugar levels in diabetes mellitus and halting or decreasing the consumption of broad-spectrum antibiotics. Intertriginous areas (skin folds) must be kept free of moisture. One way of achieving that is by wiping such regions after a bath. Long-time immersion of hands in water must be avoided. The dermatologist may recommend lotions, oral suspensions (for oral candidiasis), or topical medication.
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