37 White lesions: Candidosis (candidiasis)
White patches may be produced by epithelial debris (e.g. “material alba” – white debris which accumulates where oral hygiene is lacking), sloughing (e.g. burns), or epithelial thickening – rarely inherited but more commonly acquired (Figure 37.1) (Table 37.1). Superficial conditions such as debris or candidosis can be wiped away with a dry gauze (Figure 37.2).
(Also called “thrush” in UK and some other countries.)
Definition: Lesions consist of white flecks, plaques or nodules, which will wipe off with gauze.
Prevalence (approximate): Uncommon.
Age mainly affected: Neonates and adults.
Gender mainly affected: M = F.
Etiopathogenesis: Candida albicans is a harmless commensal yeast in the mouths of nearly 50% of the population (carriers). Oropharyngeal candidosis may be seen in healthy neonates as they have yet to acquire immunity. Local ecological changes such as a disturbance in the oral flora (e.g. by antibiotics, xerostomia), or a decrease in immune defences (e.g. by immunosuppressive treatment or immune defects (HIV/AIDS, leukemias, lymphomas, cancer, diabetes)), can allow Candida to become an opportunistic pathogen (Figure 37.3). There is also an increase in/>