Oral Candida - DIAN

Question 1

Presentation of pseudomembranous candidiasis?

Answer 1

White patches that look like milk curds
- can be wiped off to reveal a bleeding / erythematous base
- usually painless

Question 2

Tx of Pseudomembranous candidiasis?

Answer 2

Identify underlying cause
- diabetes
- HIV
- smoker

Improve oral hygiene
- chlorhexaidne use
- antifungal use, fluconazole best - dose according to age

Question 3

Appearance of chronic hyperplastic candidiasis?

Associated with?

Answer 3

White patch on comissures, buccal mucosa or dorsum of tongue

Associated with vitamin deficiency and heavy smokers
- can be malignant

Question 4

Tx of C H C?

Answer 4

Biopsy and histopathological analysis to confirm diagnosis

• check vitamin levels
• stop smoking

2-4 weeks of fluconazole

Question 5

Appearance and associations with acute erythematous/atrophic candidiasis?

Answer 5

Red shiny atrophic mucosa

• chronic use of steroids/ antibiotics/ immunosuppression/ xerostomia

Question 6

Tx of erythematous / atrophic candida?

Answer 6

Use spacer device for inhaler / rinse after

• treat as for oral thrush

Question 7

Appearance / signs of chronic erythematous candida?

Answer 7

Diffuse redness in denture bearing area
- often asymptomatic
- leaves denture in overnight

Question 8

Tx of chronic erythematous candidiasis?

Answer 8

Remove denture at night
- promote good denture hygiene
- cleaning instructions

Miconazole on area / on denture base

Refer to GMP if suspected systemic issue
- vitamins, steroid meds, endocrine

Question 9

Causes of angular chelitis?

Answer 9

Reduced OVD

Trauma

Immunosuppression

Malabsorption
- crohns or coeliac

Iron/b12 deficient

Existing candida infection