Chronic Mucocutaneous Candidiasis: A Case Report.

Area of Science:

• Dermatology
• Infectious Diseases
• Genetics

Background:

• Chronic mucocutaneous candidiasis (CMC) is a rare disorder characterized by persistent Candida infections of the skin, nails, and mucous membranes.
• Early diagnosis and management are crucial due to potential complications and a guarded prognosis.

Observation:

• A pediatric case of CMC presented with oral leukoplakia, facial/limb skin lesions, and confirmed Candida albicans infection.
• Initial treatment with itraconazole led to temporary remission, followed by relapse and subsequent development of hypoparathyroidism.
• Genetic analysis ruled out STAT1 mutations, a common cause of CMC, and no significant immunodeficiency or endocrine issues were initially detected.

Findings:

• The study identified Candida albicans as the causative agent, sensitive to itraconazole and nystatin.
• Absence of STAT1 mutations and initial lack of immunodeficiency/endocrine abnormalities were noted.
• Late-onset hypoparathyroidism developed a year after initial presentation, a rare complication in CMC.

Implications:

• Recurrent superficial fungal infections warrant consideration for CMC, even in the absence of typical genetic markers.
• The case underscores the importance of long-term monitoring for systemic complications like hypoparathyroidism in CMC patients.
• This report provides valuable insights for clinicians regarding the diagnosis and management of CMC, particularly in atypical presentations.