Etiology and Pathophysiology

Contributory factors :

Prevalence

  • Most commonly presented in patients with poor immune system function

Histological Features

  • Hyphae penetrate the epithelium up to the spinous cell layer
  • Presence of oedema
  • Micro-abscesses containing polymorphonuclear leukocytes wtihin the outer layers of the epithelium
  • Deeper parts of the epithelium show acanthosis and inflammatory infiltrate

Clinical Features

  • Semi-adherent, whitish, soft and cream, drop-like or confluent patches. They can be removed, leading to a red and slightly bleeding surface
  • Lesions may recur in patients using corticosteroids, HIV or immunocompromised

Location

Acute form: Palate, dorsum of the tongue, buccal mucsoa Chronic form: Palate, oropharynx, dorsum of tongue

Appearance

Differential Diagnoses

Relevant Clinical Investigations

Patient Management

  • stop topical corticosteroids for 2 weeks
  • apply topical antifungals (miconazole gel preferred, amphotericin lozenges if contraindication)
  • resume corticosteroids