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[Candida vasculitis]
J L Bourrain1, J C Béani, P Amblard
1Service de Dermatologie, CHU de Grenoble.
Abstract:
Apart from direct skin attacks, yeasts of the Candida group hold a place that is much discussed in the occurrence of immuno-allergic reactions of the skin, because of their usual saprophytic characteristics. We report here on observation of a patient of 62 years who presented with a secondary purpuric maculo-papular eruption making a tri-symptom of Gougerot, for which we have incriminated the role of the immunogenicity of Candida. Skin histology confirmed the presence of an angiitis and necrotising capillarity. An intradermal test with candidine reproduced the skin symptoms and histology, whilst other microbial and fungal tests remained within normal limits. Other examinations showed the transitory presence of circulating immune complexes, although the remainder of the immunity factors were negative. A digestive focus of Candida was present. Recovery occurred after systemic mycological treatment was started, though there was a return of symptoms after a temporary initial check.
Insights
Candida yeasts can trigger rare skin reactions like Gougerot
Area of Science:
- Dermatology
- Immunology
- Mycology
Background:
- Candida yeasts are common, often harmless inhabitants of the skin.
- Their role in immuno-allergic skin reactions is debated.
- Saprophytic fungi can sometimes trigger immune responses.
Observation:
- A 62-year-old patient presented with a purpuric maculo-papular eruption, a rare triad of symptoms.
- Skin biopsy revealed angiitis and necrotizing capillaritis.
- Intradermal candidin testing reproduced the patient's symptoms and histological findings.
Findings:
- The patient's eruption was linked to Candida immunogenicity.
- Circulating immune complexes were transiently detected.
- A digestive Candida focus was identified, but other microbial tests were normal.
Implications:
- This case highlights Candida's potential to induce severe cutaneous immuno-allergic reactions.
- Angiitis and necrotizing capillaritis may be manifestations of fungal hypersensitivity.
- Systemic antifungal treatment can be effective, though relapse is possible.