Oral candidiasis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Oral infections of candida usually appear as thick white or cream color deposits. Underlying the deposits the mucosa of the mouth may appear inflamed (red and possibly slightly raised). Oral lesions are painless, white patches in the mouth.

Pseudomembranous oropharyngeal candidiasis:

  • Candida lesions appear as white plaques on the mouth and tongue.
  • Trying to remove the patches with tongue depressor will leave an erythematous area and sometimes bleeding (which differentiates it from lichen planus).[1]

Atrophic oropharyngeal candidiasis:

  • It’s also called denture stomatitis.[2]
  • On inspection, lesions appear as erythematous areas with no white plaques.
  • Lesions are usually found in the site of the fitting contact of the dental dentures (hence its name).

Hyperplastic oropharyngeal candidiasis (candidal leukoplakia):

  • Plaques are usually found on both sides of the buccal mucosa (less often on the tongue)[3]
  • Appear as rough irregular nodular lesions on an erythematous base
  • Non homogenous (speckled) leukoplakias are seen frequently

Chronic mucocutaneous candidiasis:

  • This syndrome is characterized by recurrent or persistent candidal infection in the mouth, tongue, scalp and nails.
  • Due to chronicity of the infection, it’s usually associated with disfigurement and thickness of the affected areas. Nails appear brittle and broken.
  • In rare cases, condition might progress into systemic candidiasis (usually if accompanied by another immunocompromisation).[4]
  • Patients frequently have accompanying autoimmune disorders as hypopararthyroidism, diabetes or Grave’s disease.

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References

  1. Akpan A, Morgan R (2002). "Oral candidiasis". Postgrad Med J. 78 (922): 455–9. PMC 1742467. PMID 12185216.
  2. Budtz-Jørgensen E (1981). "Oral mucosal lesions associated with the wearing of removable dentures". J. Oral Pathol. 10 (2): 65–80. PMID 6792333.
  3. Sitheeque MA, Samaranayake LP (2003). "Chronic hyperplastic candidosis/candidiasis (candidal leukoplakia)". Crit. Rev. Oral Biol. Med. 14 (4): 253–67. PMID 12907694.
  4. Kirkpatrick CH (2001). "Chronic mucocutaneous candidiasis". Pediatr. Infect. Dis. J. 20 (2): 197–206. PMID 11224843.
  5. "Public Health Image Library (PHIL)".

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