Not to be confused with secondary oral candida lesions
Secondary lesions are:” Oral lesions that are a manifestation of generalized systemic or mucutaneous candidal infections Contemporary Oral Medicine A Comprehensive Approach to Clinical Practice TOC]
Etiology and Pathophysiology
In addition to the three typical variants of oral candidosis, there are other oral lesions associated with the presence of candida where yeasts are not the unique etiological agents
Angular Cheilitis
A chronic inflammatory lesion of the labial commissures that can be affected unilaterally or bilaterally
Contributory factors :
- Candida and Staph aureus are implicated in the etiology but there are other predisposing factors
- predisposing factors:
- anemia/ vitamin B12 Deficiency
- Impaired immunity
- Saliva maceration of tissues (due to facial skinfolds along labial commissures in patients with reduced OVD)
Prevalence
Histological Features
Clinical Features
- usually symptomatic and both the skin and oral mucosa may be affected
Location
- Angles of the mouth (labial commissures)
Appearance
- appears as erythematous fissured lesions at the angles of the mouth
Differential Diagnoses
Relevant Clinical Investigations
Patient Management
- Increase vdo to the proper height to reduce skinfolds
- Discourage lip licking habits
Median Rhomboid Glossitis
Contributory factors :
- Candida
Aetiology is highly contentious and antifungal therapy often doesn’t result in resolving the lesion
Prevalence
- A predilection for middle aged men consuming tobacco has been reported (with an incidence that varies from 0.2 % - 3% )
Histological Features
- epithelium wiht loss of papillae and a variable degree of hypreplasia
- pseudoepitheliomatous with elongated ret pegs
- variable hyperparakeratosis
- submucosal lymphocytic infiltrate
- fungal hyphae can usually be found in parakeratin and/or invading the spinous layers
Clinical Features
- asymptomatic, symmetric, flat and smooth lesion
- may be lobulated or mamillary in some cases
Appearance
- Characterized by an erythematous atrophic area more or less rhomboidal in shape, located in the mid-posterior part of the dorsum of the tongue slightly anterior to the circumvallate papillae
Differential Diagnoses
Relevant Clinical Investigations
Patient Management
Denture - Associated Erythematous Stomatitis
Contributory factors :
Prevalence
The most frequent form of oral candidosis affecting up to 50-75% of denture wearers
Histological Features
Clinical Features
Lesions can be classified into 3 types based on their extension :
- I: Localized inflammation or pinpoint hyperemia
- II: More diffuse erythema involving part of , or the entire, denture-covered mucosa
- III: granular or papillary type (inflammatory papillary hyperplasia) involving the central part of the hard palate and alveolar ridges