Chronic mucocutaneous candidiasis is a bacterial immunodeficiency disorder characterized by persistent Candida infections of the skin, mucous membranes, hair, and nails. Unlike other cellular immunodeficiency diseases, this condition only exhibits a lack of response to Candida albicans and a few antigenically related fungi, while maintaining normal immunity against viruses, bacteria, and other microorganisms. This disease is a syndrome associated with various conditions, often accompanied by functional impairments of endocrine organs, tumors, and other chronic debilitating diseases. It may also occur during the use of immunosuppressive agents.

bubble_chart Clinical Manifestations

It occurs more frequently in females and can develop at any age. Infants often have persistent thrush. Mild cases may only affect the nails, while severe cases involve the skin, mucous membranes, and hair throughout the body. The skin may exhibit scales and eczema; mucous membranes may show adherent white patches of Candida; nails may suffer from dystrophy or hyperkeratosis. Chronic esophageal candidiasis can lead to esophageal stricture and may be accompanied by sinus and lung infections. Affected children may experience growth and developmental delays. Cases in the elderly are generally milder.

Another type is juvenile familial polyendocrine syndrome with candidiasis, which, in addition to mild to grade II candidiasis, typically manifests hypothyroidism, hypoparathyroidism, Addison's disease, or diabetes several years after the onset of candidiasis. Usually, autoantibodies against the affected endocrine organs can be detected. Additionally, complications may include ovarian dysfunction, pernicious anemia, alopecia areata, and chronic active hepatitis.

bubble_chart Auxiliary Examination

The manifestations of immunodeficiency in this disease vary. The most prominent abnormalities include cutaneous anergy to Candida, absence of in vitro proliferative responses to Candida antigens, and diminished synthesis of lymphokine migration inhibitory factor. However, antibody responses to Candida and other antigens remain normal. Immunoglobulin levels are normal or elevated; T-cell and B-cell counts are generally normal, but monocyte function is impaired.

The main treatment is antifungal therapy. For oral use, Chinese Gentian Violet, nystatin, and clotrimazole can be applied; systemic treatment involves ketoconazole and amphotericin B. Nail fungus can be surgically removed. Immunostimulation with transfer factor, combined with amphotericin B, can enhance efficacy and reduce drug toxicity. Additionally, thymic epithelial cells, thymic hormones, or immune lymphocytes can be used for treatment, achieving temporary therapeutic effects.