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Noorahmah Adiany Ansari 110 207 005

Eko Wahyuddin S 110 208 063

Counselor supervisor : dr. A.M.Adam, Sp.KK (K)

Adviser : dr. Sari Handayani P.

MUCOCUTANEUS CANDIDIASIS

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DEFINITIONCandidiasis is a fungal disease, which is acute or subacute

caused by Candida species usually by the species Candida

albicans, and can affect the mucous membranes, skin, nails,

GI tract, and can also infect the organ in systemic.

The synonim of Candidiasis are Candidosis or Moniliasis

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EPIDEMIOLOGYCandidiasis disease found worldwide, can affect all ages, both male

and female. Candidiasis also associated with predisposing factors

endogenous and exogenous

predisposing factors

pregnancy, obesity,

Endokrinopati,

Contact with patients with

sexually transmitted diseases

Chronic Disease

AGE

Temperature and high humidity,

Hygiene of skin

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ETIOLOGYCandida albicans is the yeast in the oval size 2-6

× 3-9 μM that can produce stem cells,

pseudohyphae, and true hyphae.

Figure 1. Candida in Pottasium hydroxide preparation.

Pseudomycelia in clusters of grape-like yeast cells

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CLASSIFICATION

Classification of Candidiasis infection based on the

site of predilection which is on mucocutan candidiasis,

systemic candidiasis, cutis candidiasis, and chronic

mucocutaneus candidiasis.

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CLASSIFICATION continue…Based on an exposed spot, Conant et al (1971) share as a local

candidosis which can be distinguished clinically:

Candidiasis of mucous membranes (mucocutaneous):

1. Oral candidiasis (thrush)

2. Perleche

3. Vaginalis candidiasis (vulvovaginitis)

4. Balanitis or balanopostitis

5. Chronic mucocutaneous candidiasis

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predisposing factors

C. albicans penetrate the mucosal epithelial

cells

decreased immunity

Blastospora develop into hyphae and pseudo-hyphae apparent pressure from the

tissue damage, so the invasion into the tissue can

occur.

C.Albicans invasion into the tissue

holding the patient's body

Attachment of microorganisms in the host cell tissue

Tissue damage

supported by molecular enzymes of candida albicans

PATHOGENESIS

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Oral Candidiasis (Thrush).white looks gray pseudomembrane that covers

the tongue, palate mole, inner cheek, and other oral cavity surfaces

Figure 2. Oral candidiasis: thrush Extensive cottage cheeselike plaques, colonies of Candida (pseudomembranous), Patches of erythema between the white plaques represent erythematous (atrophic) candidiasis.

CLINICAL MANIFESTATION

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PerlecheLesions in the form of fissures or cracks in the skin

at an angle of mouth; lesions underwent maceration, erosion, wet, and basically erythematous.

Figure 3. Candida perleche with erythema and fissuring at the corners of the mouth.

CLINICAL MANIFESTATION continue…

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Vulvovaginitis. white patches on erythematous mucosa erosive, ranging from

the cervix to the introitus vagina, and especially the vagina 1/3 bottom. the lump apart from the mass of the vulva or vagina wall is composed of necrotic material, epithelial cells, and fungi.

Figure 4. Vulvovaginal candidiasis. Figure 5. Vulvovaginal candidiasis. White patches appear on the White patches appear on theerythematous mucosa in the labia major erythematous mucosa in the cervixand minor

CLINICAL MANIFESTATION continue…

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Balanitis or balanopostitiswhite patches on the membrane of the glans penis is often entirely become erythematous and erosive

Figure 6. candidiasis : balanoposthitis. Figure 7 .Erythema and white plaques several discrete pustules on the glans seen on the glans penis penis and in the prepusium. and prepusium

CLINICAL MANIFESTATION continue…

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Chronic mucocutaneous candidiasis. This disease arises because of the lack of leukocyte function or hormonal systems, usually found in patients with a variety of genetic deficiency, generally found in children - children.

Figure 7. Mucocutaneous candidiasis of the scalp of patients with chronic.

CLINICAL MANIFESTATION continue…

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1. Anamnesis and Physical Examination

2. Direct examination.Mucocutaneous swabs examined with 10% KOH solution or by Gram staining : yeast cells, blastospora, or pseudo hyphae.

Figure 8. Candida albicans: KOH preparation: Budding yeast forms and sausage-like form of pseudo hyphae

.

DIAGNOSIS

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2. Examination of culturesMaterial to be examined in order to be planted in

Sabouraud dextrose glucose, can also be affixed to these antibiotics (chloramphenicol) to prevent bacterial growth.

Figure 9. Colonies of Candida albicans.

DIAGNOSIS continue….

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1. Oral Candidiasis (Thrush)

Leukoplakia is a clinical term

that refers to an oral mucosal

white patch that will not be

contagious.

Figure 10. Hairy leukoplakia appears as a broader and plaques on the lateral folds of the tongue

DIFFERENTIAL DIAGNOSIS

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2. Trichomonas vaginalis

Vulvovaginitis with vaginal secretions

There is a yellow-green secretions,

smells bad and frothy, vaginal walls

are reddish, and there are strawberry

appereance of the cervix.

Figure 11. This patient presented with a "strawberry cervix" due to a Trichomonas vaginalis infection, or trichomoniasis. The term "strawberry cervix" is used to describe the appearance of the cervix . The cervical mucosa reveals punctate hemorrhages along with accompanying vesicles or papules.

DIFFERENTIAL DIAGNOSIS continue…

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2. Lichen Planus

lichen planus occurs mainly on

the buccal mucosa, often

bilateral, and sometimes on the

tongue dorsal or lateral.

Figure 12. Oral Lichen planus

DIFFERENTIAL DIAGNOSIS continue…

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1. Avoid or eliminate the predisposing factors.

2. Topical

3. Systemic

MANAGEMENT

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Leukoplakia patients can be a squamous carcinoma,

although rarely.

Patients with AIDS oral candidiasis, chronic

mucocutaneous candidiasis, can be an esophageal candidiasis.

Candidiasis Vulvovaginalis or who have chronic

Candidiasi Vulvovaginalis can lead to chronic dyspareunia to

disrupt the marital relationship.

COMPLICATIONS

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Prognosis of mucocutaneous candidiasis is

generally good and depends on the severity of

the predisposing factors.

PROGNOSIS

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THANK YOUSpecial thanks to our supervisor and

adviser