​Dermatology - Oropharyngeal Candidiasis

​Dermatology - Oropharyngeal Candidiasis

Oral cavity infection with Candida spp. is caused by slight changes in host variables such as antibiotic medication, glucocorticoid therapy, age (infants, elderly), and weakened host defenses.

Oropharyngeal candidiasis frequently lacks symptoms, although individuals may have a sensation of burning or pain when consuming spicy or acidic foods, as well as a reduced ability to taste. Orodynophagia is present.

Thrush refers to the presence of colonies of Candida, which appear as white cottage cheese-like flecks on any mucosal surface. These flecks can range in size from 1-2 mm to covering the entire mucosal surface. Using a dry gauze pad to remove anything results in a red and inflamed mucosal area. Atrophic candidiasis manifests as a tongue that is smooth, red, and has undergone atrophy. Thrush may also manifest in some areas. Candida leukoplakia refers to the existence of white plaques that are resistant to removal. Angular cheilitis refers to the presence of candida intertrigo near the corners of the lips.

The diagnosis is established through clinical examination using potassium hydroxide (KOH) microscopy. The differential diagnosis comprises several conditions, including oral hairy leukoplakia, condyloma acuminatum, geographic tongue, hairy tongue, lichen planus, bite irritation, poor nutrition, and vitamin insufficiency.

Eliminate or cease the use of any factors that may contribute to a condition, if feasible.
Local treatment
Apply either nystatin or clotrimazole cream.
Systemic therapy 
Administer oral fluconazole, itraconazole, or ketoconazole. Administer amphotericin B to treat severe cases of drug-resistant illness.