Yeast species and biotypes associated with oral leukoplakia and lichen planus

Of 36 patients, 17 had oral leukoplakia, including homogeneous and nonhomogeneous types, and 19 had reticular lesions of oral lichen planus. A sample of yeast flora in each patient was taken from the pathologic lesion as well as from normal-appearing mucosa. The isolated yeasts were identified according to species level, and identification was extended beyond the species level for one species, Candida albicans, to reveal the biotype by means of the Odds and Abbott procedure comprising tests for acid and salt tolerance, proteinase production, resistance to 5-fluorocytosine and safranine, and assimilation of urea, sorbose, and citrate. Yeasts were present in the lesions of 82% of leukoplakia patients, compared to 37% of lichen planus patients, a frequency of yeasts corresponding to that in healthy adults. C. albicans was the dominating species in lesions of both diseases, constituting 82% of all yeasts in the leukoplakia lesions. In addition, the following species were identified: Candida tropicalis, Candida pintolopesii, Torulopsis glabrata, and Saccharomyces cerevisiae. Eighteen biotypes of C. albicans were encountered, the most frequently occurring biotypes being 355 and 177. Differences between C. albicans biotypes isolated from pathologic and normal mucosa were encountered in five of eleven leukoplakia patients and in one of three lichen planus patients. This indicates that the oral cavity comprises several ecologic niches for yeasts. As nonhomogeneous leukoplakias are more likely to develop into carcinoma than are homogeneous leukoplakias, it is interesting to note that the C. albicans biotypes isolated from nodular lesions (one type of nonhomogeneous leukoplakia)--biotypes 145, 175, and 575--rarely occur.(ABSTRACT TRUNCATED AT 250 WORDS)