How to treat Chronic Mucocutaneous Candidiasis?
Chronic mucocutaneous candidiasis (CMC) refers to a heterogeneous group of disorders characterized by recurrent or persistent superficial infections of the skin, mucous membranes, and nails with Candida organisms, usually Candida albicans. These disorders are confined to the cutaneous surface, with little propensity for systemic dissemination. CMC does not represent a specific disease, but rather a phenotypic presentation of a spectrum of immunologic, endocrinologic, and autoimmune disorders. The unifying feature of these heterogeneous disorders is impaired cell-mediated immunity against Candida species.
@sahana Management can be difficult, and relapse is common following discontinuation of therapy. Topical therapies are not usually effective in patients with chronic mucocutaneous candidiasis (CMC). Treatment of oral involvement in CMC can be aided by therapy with clotrimazole troches or oral nystatin solution. Treatment falls into three main categories: antifungal agents, immunologic therapies, and combination therapy. Systemic antifungal therapy is the mainstay of CMC therapy. It may be used alone or in combination with an immunomodulatory agent. The drawbacks of systemic antifungal therapy include the risk of adverse effects or toxicity, a failure to correct the underlying immune deficiency, relapse following the cessation of therapy, and antifungal resistance to some antifungal agents. It is estimated that 40% of patients receiving long-term antifungal treatment develop drug resistance, although lower frequency is observed with intermittent therapy.