What causes cutaneous candidiasis?

Updated: Jan 17, 2020
  • Author: Richard Harold "Hal" Flowers, IV, MD; Chief Editor: Dirk M Elston, MD  more...
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Host factors that predispose patients to infections include local factors, endocrine diseases, nutritional deficiencies, and systemic immunodeficiency. Local factors such as tissue damage resulting from trauma, xerostomia, radiation-induced mucositis, ulcerations, skin maceration, or occlusion enhance adhesion and predispose patients to increased infection rates. Cutaneous candidiasis has been reported to be more common in women than in men. [18, 19]

Nutritional deficiencies may alter host defense mechanisms or epithelial barrier integrity, allowing increased adherence or penetration. Iron deficiency anemia and deficiencies including vitamins B-1, B-2, B-6, C, and folic acid are associated with heightened infection rates. [20, 21]

Endocrine diseases such as diabetes mellitus, Cushing syndrome, hypoparathyroidism, hypothyroidism, and polyendocrinopathy are also associated with increased susceptibility to infection. The mechanism by which diabetes mellitus is believed to raise infection rates is through increased tissue glucose, altered yeast adhesion, and decreased phagocytosis. [22] Chronic mucocutaneous candidiasis refers to recurrent and chronic Candida infections of the epidermis, nails, and mucosal membranes. It is associated with a variety of autoimmune conditions and endocrine disorders. [23]

T-lymphocyte–mediated immunity plays an important immunologic role against infection through phagocytosis and killing by polymorphonuclear cells and macrophages. Individuals with deficient T-lymphocyte function, such as patients with AIDS, appear to be particularly vulnerable to mucosal or cutaneous candidiasis. Patients with primary immune deficiencies, such as lymphocytic abnormalities, phagocytic dysfunction, IgA deficiency, viral-induced immune paralysis, and severe congenital immunodeficiencies, often are affected by oropharyngeal candidiasis and other fungal mycoses. [24]

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