Chronic mucocutaneous candidiasis

Chronic mucocutaneous candidiasis is an immune disorder of T cells marked by long-lasting infections with Candida fungi that stay on the mucous membranes, skin and nails. It can also come with other infections, such as human papilloma virus, and with endocrine dysfunction, vitiligo, malabsorption syndromes and neoplasms. In most patients the cause is abnormal cell-mediated immunity: T lymphocytes fail to produce the cytokines needed for defense against Candida, and mutations that affect the interleukin-17 pathway weaken the immune response. It can be inherited in an autosomal dominant or autosomal recessive way, with nine recognized types, the first of them (CANDF1) mapped to chromosome 2. Recorded signs include thickened skin, skin ulcers, vision problems, hepatitis, seizures and meningitis. Management uses systemic antifungal therapy such as fluconazole, transfer factor and combination therapy, and relapse often follows when treatment stops. Patients with autosomal dominant disease may be at risk of esophageal cancer from nitrosamines produced by chronic Candida infection. This entry records what is documented and is not medical advice.