Superficial candidiases and treatment options

Candidiasis is the most frequent mycosis with a number of different clinical presentations of varying severity. Superficial candidiases

include intertriginous candidiasis; mucosal candidiasis – oral, vulvar and vaginal; balanitis and balanoposthitis; paronychial candidiasis;

and chronic mucosal and cutaneous candidiasis. The clinical course is usually chronic and recurrent; however, there may be

candidiases with a severe, life-threatening course. The diagnosis should be established based on evaluation of history, clinical finding,

native microscopy, and culture result. Most Candida infections (more than 90%) are caused by five most commonly occurring species

– Candida albicans, Candida parapsilosis, Candida tropicalis, Candida glabrata and Candida krusei. A precondition for colonization

is the adherence of Candida species to the mucosal epithelium. The Candida C3d protein that binds to cell surface participates in

the adherence, as do proteolytic enzymes, toxins, and yeast phospholipase. The host susceptibility to colonization of the skin and

mucosae by yeast is contributed to by several factors simultaneously. Local treatment for superficial candidiases includes imidazoles,

triazoles, allylamines, and nystatin. Granulomatous and invasive forms of candidiases are treated locally and systemically with triazoles,

allylamines (terbinafine), echinocandins (caspofungin), and amphotericin B. The treatment involves elimination of associated

factors that promote the development of infection. For resistance purposes, the possibility of determination of yeast sensitivity to

antifungal drugs should be available.

Keywords: superficial candidiases, clinical precentation, treatment