Chronic Mucocutaneous Candidiasis: A Case Report

Abstract

Chronic mucocutaneous candidiasis (CMC) is a rare infectious skin disease. This study reported a case of CMC in a child with clinical manifestations of oral mucosal leukoplakia and erythema and crust-like thick scabs on the skin of the face and upper limbs. Microscopic fungal examination revealed a large amount of pseudohyphae, and the fungal culture indicated Candida albicans. A drug sensitivity test indicated that it was sensitive to itraconazole and nystatin. Laboratory tests did not show significant immunodeficiency or endocrine abnormalities, and gene sequencing did not identify DNA gene mutations in the coiled-coil domain (CCD) or the DNA-binding domain (DBD) of signal transducer and activator of transcription 1 (STAT1). The skin lesions subsided after oral administration of itraconazole but relapsed 6 months later, and hypoparathyroidism occurred 1 year later. Patients with repeated superficial fungal infection should be alert to the possibility of CMC. CMC has numerous complications and a poor prognosis that requires the attention of clinicians. In this case, STAT1 mutation was not found, and parathyroid dysfunction was rare, providing reference for clinical diagnosis and treatment of CMC.

Keywords: Candida albicans; children; chronic mucocutaneous candidiasis; hypoparathyroidism; itraconazole.

Figure 1

Clinical manifestations of CMC. (A) Facial lesions before treatment, with visible red plaques covered with thick brown scabs. (B) After 1 month of itraconazole treatment, the thick scabs had disappeared, and the plaque area was reduced and flattened.

Figure 2

Microbiological examination of CMC. (A) CHROMagar chromogenic medium showed green colonies, which were uplifted, moist, smooth, and pearly. (B) The drug sensitivity test identified sensitivity to itraconazole, nystatin, and 5-fluorocytosine and moderate sensitivity to terbinafine.