Mucosal cutaneous candidiasis is a fungal infection caused by a yeast called candida, forming part of the normal flora (saprophytic or commensal) of the digestive tract and the vaginal mucosa.

Candidiasis is due to the transformation of this saprophytic yeast into a pathogenic filamentous form which can adhere to the mucous membranes and invade them.

About ten species of candida are potentially pathogenic for humans, but it is candida albicans which is the most frequently found.

Risk factors  

Candidiasis is an opportunistic infection, meaning that it only develops in the event of favorable conditions.

Some of the risk factors for candidiasis include:

Diabetes

This is the first contributing factor that the doctor will look for, especially in the event of a profuse or recurrent form of candidiasis.

Maceration

Particularly in the event of skin involvement of the inguinal, intergluteal, interdigital folds, etc.

Antibiotic therapy

Broad-spectrum antibiotics kill the natural flora of the mucous membranes, promoting the multiplication of candida.

Irritation of the mucous membrane

Sexual intercourse, dry mouth are contributing traumatic factors

L’immunodépression

By taking immunosuppressants, cortisone, AIDS …

Symptoms of candidiasis

In cutaneous forms

Cutaneous candidiasis is manifested above all by intertrigos (redness) of the large folds (inguinal, abdominal, inframammary, axillary and intergluteal folds), and small folds (labial commissure, anus, interdigital spaces, rarely inter toe spaces).

The symptoms are identical: the onset of redness at the bottom of the fold, then extension on either side of the adjacent skin surfaces. The skin is red, varnished and oozing in appearance, cracked at the bottom of the fold which is sometimes covered with a whitish coating, the outlines are irregular, limited by a border in “desquamative collar”, and the presence of small pustules in periphery are very evocative.

Sometimes the skin involvement is dry and flaky.

In the hands, the attack often results from repeated contact with water, mechanical or chemical trauma, application of topical corticosteroids, etc.

The intertrigos of the large folds are related to humidity, maceration or the extension to the skin of a digestive or genital mucous candidiasis.

In nail forms

Most often, the attack begins with perionyxis (redness and swelling of the skin around the nail), sometimes with discharge of pus under pressure.

The nail is affected secondly, and it often takes on a greenish yellow, brown or black tint, especially in the lateral areas.

The attack often results from repeated contact with water, mechanical or chemical trauma, application of topical corticosteroids, repression of the cuticles, etc.

In mucous forms

Oral candidiasis

The most common manifestation is thrush or oral candidiasis. On a red mucosa

Small white areas appear like “curdled milk” more or less adherent on the inner face of the cheeks, gums, palate, pillars of the tonsils …

Frequent in children, it can be seen in adults, especially in cases of immunosuppression.

Vaginal candidiasis

It causes redness, itching and white discharge called “curdled”.

It is estimated that 75% of women have had or will have one or more episodes of vaginal candidiasis. Among them, 10% suffer from a recurrent form defined by more than four episodes per year. It is not a sexually transmitted disease but an opportunistic infection that can be favored by sexual intercourse due to trauma to the mucous membranes or exceptionally due to a profuse balanitis of the partner. The phases of the cycle (predominant role of the natural progesterone level) and pregnancy could also be beneficial.

The balanite candidosique

The man has redness of the balanopreputial furrow, sometimes covered with a whitish coating and sprinkled with small evocative pustules.

In humans, genital candidiasis is often linked to repeated or chronic local irritations forming the bed of infection during intercourse with an infected partner, or to the existence of diabetes which should be investigated in principle.