Irina Margaritescu, MD, DipRCPath

Bruce R. Smoller, MD

Red, moist, glistening, macerated papules and plaques image and satellite pustules image located in a submammary fold are typical for candidal intertrigo.

Biopsy taken from a satellite pustule shows a subcorneal and intraepidermal pustular dermatitis. Similar findings can be seen in psoriasis and dermatophytosis.



  • Candidiasis

  • Moniliasis

  • Thrush

  • Oidiomycosis


  • Common superficial infection of skin and mucous membranes caused by yeasts of genus Candida


Infectious Agents

  • C. albicans is the predominant causal organism of most candidal infections

    • Oval yeast 2-6 by 3-9 µm in size

    • Produce budding cells, pseudohyphae, and true hyphae

  • Other species, including C. krusei, C. glabrata, C. dubliniensis, and C. inconspicua isolated from severely immunocompromised patients


  • C. albicans is not a normal cutaneous saprophyte but usually colonizes oropharynx, gastrointestinal tract, and vagina

  • Alteration in host defenses, either localized or generalized, allows organism to become pathogenic

    • Factors predisposing to infection include

      • Mechanical factors (trauma, occlusion)

      • Nutritional factors (iron deficiency, malnutrition)

      • Physiologic alteration (menses, pregnancy)

      • Systemic illnesses (diabetes mellitus, malignancy, uremia, immunodeficiency states)

      • Iatrogenic causes (antibiotics, steroids)

    • Virulence factors include surface adhesion molecules and proteinase enzymes



  • Incidence

    • Common in groups at risk (immunocompromised patients)

  • Age

    • Any age

  • Gender

    • Both sexes


  • Various mucosal and cutaneous manifestations

  • Oral candidiasis may appear in acute or chronic forms

    • Acute pseudomembranous candidiasis or thrush

      • Most common form of oral candidiasis

      • Occurs in neonates or in adults usually secondary to local or general predisposing factors

      • Discrete white patches on buccal mucosa, tongue, palate, and gingivae, which, when removed, leave a raw and brightly erythematous surface

    • Acute erythematous (atrophic) candidiasis

      • May occur de novo or after sloughing of pseudomembrane

      • Commonly associated with antibiotics and steroid treatments

      • Marked soreness and depapillated erythematous areas on dorsal surface of tongue

    • Chronic pseudomembranous candidiasis

      • Occurs principally in immunocompromised patients

      • Very persistent lesions

      • Very similar clinically to acute pseudomembranous form

    • Chronic erythematous candidiasis (denture stomatitis)

Jul 8, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Candidiasis

Full access? Get Clinical Tree

Get Clinical Tree app for offline access