Abstract
Chronic mucocutaneous candidiasis can be defined as a group of syndromes that have as a common feature infections of the skin, nails and mucous membranes withCandida albicans. A variety of disorders including endocrine dysfunctions, alopecia, vitiligo, malabsorption syndromes, neoplasms and other infections may also occur in patients with chronic mucocutaneous candidiasis, but these vary considerably from patient to patient. In most patients with chronic mucocutaneous candidiasis, there are abnormalities of cell-mediated immunity. These may be limited to antigens ofCandida albicans, but in some patients they are more extensive and involve the T-lymphocyte-mediated responses to all antigens. These immunulogic defects are the factors that predispose patients to infections with opportunistic organisms such asCandida spp. Fungal infections in patients with chronic mucocutaneous candidiasis usually respond to treatment with conventional antifungal agents, but often relapse shortly after treatment is stopped unless the defects in the cell-mediated immune system have been corrected.
Similar content being viewed by others
References
Kirkpatrick, C. H., Rich, R. R., Bennett, J. E. Chronic mucocutaneous candidiasis: Model-building in cellular immunity. Annals of Internal Medicine 1971, 74: 955–978.
Kirkpatrick, C. H., Sohnle, P. G. Chronic mucocutaneous candidiasis. In: Safai, B., Good, R. A. (ed.): Immunodermatology. Plenum Publishing, New York, 1981, p. 495–514.
Lehner, T. Classification and clinico-pathological features of candida infections of the mouth. In: Winner, H. I., Hurley, R. (ed.): Symposium on candida infections. Williams and Wilkins, Baltimore, 1966, p. 119–136.
Higgs, J. M., Wells, R. S. Chronic muco-cutaneous candidiasis: associated abnormalities of iron metabolism. British Journal of Dermatology 1972, 86, Supplement 8: 88–102.
Cawson, R. A. Chronic oral candidiasis, denture stomatitis, and chronic hyperplastic candidosis. In: Winner, H. I., Hurley, R. (ed.): Symposium on candida infections. Williams and Wilkins, Baltimore, 1966, p. 138–152.
Blizzard, R. M., Gibbs, J. H. Candidiasis: Studies pertaining to its association with endocrinopathies and pernicious anemia. Pediatrics 1968, 42: 231–237.
Louria, D. B., Shannon, D., Johnson, G., Caroline, L., Okas, A., Taschdjian, C. The susceptibility to moniliasis in children with endocrine hypofunction. Transactions of the Association of American Physicians 1967, 80: 236–248.
Lucky, A. W., Rebar, R. W., Blizzard, R. M., Goren, E. M. Pubertal progression in the presence of elevated serum gonadotropins in girls with multiple endocrine deficiencies. Journal of Clinical Endocrinology and Metabolism 1977, 45: 673–678.
Wells, R. S., Higgs, J. M., MacDonald, A., Valdimarsson, H., Holt, P. J. L. Familial chronic mucocutaneous candidiasis. Journal of Medical Genetics 1972, 9: 302–310.
Kirkpatrick, C. H., Windhorst, D. B. Mucocutaneous candidiasis and thymoma. American Journal of Medicine 1979, 66: 939–945.
Okamoto, G. A., Hall, J. G., Ochs, H., Jackson, C., Rodaway, K., Chandler, J. New syndrome of chronic mucocutaneous candidiasis. Birth Defects Original Article Series 1977, 13: 117–125.
Shama, S. K., Kirkpatrick, C. H. Dermatophytosis in patients with chronic mucocutaneous candidiasis. Journal of the American Academy of Dermatology 1980, 2: 285–294.
Petersen, E. A., Alling, D. W., Kirkpatrick, C. H. Treatment of chronic mucocutaneous candidiasis with ketoconazole: a controlled clinical trial. Annals of Internal Medicine 1980, 93: 791–795.
Chipps, B. E., Saulsbury, F. T., Hsu, S. H., Hughes, W. T., Winkelstein, J. A. Non-candidal infections in children with chronic mucocutaneous candidiasis. Johns Hopkins Medical Journal 1979, 44: 175–179.
Gallin, J. I., Wright, D. G., Malech, H. L., Davis, J. M., Klempner, M. S., Kirkpatrick, C. H. Disorders of phagocyte chemotaxis. Annals of Internal Medicine 1980, 92: 520–538.
Hertz, K. C., Gazze, L. A., Kirkpatrick, C. H., Katz, S. I. Autoimmune vitiligo. Detection on antibodies to melanin-producing cells. New England Journal of Medicine 1977, 297: 634–637.
Nordlund, J. J., Howanitz, N., Bystryn, J.-C., Forget, B. M., Lerner, A. M. Antipigment cell factors and mucocutaneous candidiasis. Archives of Dermatology 1981, 117: 210–212.
Truss, C. O. The role ofCandida albicans in human illness. Journal of Orthomolecular Psychiatry 1981, 10: 1–11.
Kirkpatrick, C. H. Cancer and immunodeficiency diseases. Birth Defects Original Article Series 1976, 12: 61–78.
Bodey, G. P. Candidiasis in cancer patients. American Journal of Medicine 1984, 77: 13–19.
Lehrer, R. I., Cline, M. J. Leukocyte myeloperoxidase deficiency and disseminated candidiasis: the role of myeloperoxidase in resistance toCandida infection. Journal of Clinical Investigation 1969, 48: 1478–1488.
Lehrer, R. I. Functional aspects of a second mechanism of candidacidal activity by human neutrophils. Journal of Clinical Investigation 1972, 51: 2566–2572.
Lehrer, R. I. The fungicidal mechanisms of human monocytes. I: Evidence for myeloperoxidase-independent candidacidal mechanisms. Journal of Clinical Investigation 1975, 55: 338–346.
Diamond, R. D., Krzesicki, R. Mechanisms of attachment of neutrophils toCandida albicans pseudohyphae in the absence of serum, and of subsequent damage to pseudohyphae by microbicidal processes of neutrophils in vitro. Journal of Clinical Investigation 1978, 61: 360–369.
Diamond, R. D., Krzesicki, R., Wellington, J. Damage of pseudohyphal forms ofCandida albicans by neutrophils in the absence of serum in vitro. Journal of Clinical Investigation 1978, 61: 349–359.
Diamond, R. D., Oppenheim, F., Nakagawa, Y., Krzesicki, R., Haudenschild, C. C. Properties of a product ofCandida albicans hyphae and pseudohyphae that inhibits contact between the fungi and human neutrophils in vitro. Journal of Immunology 1980, 125: 2797–2804.
Sohnle, P. G., Frank, M. M., Kirkpatrick, C. H. Mechanisms involved in elimination of organisms from experimental cutaneousCandida albicans infections in guinea pigs. Journal of Immunology 1976, 117: 523–530.
Sohnle, P. G., Kirkpatrick, C. H. Epidermal proliferation in the defense against experimental cutaneous candidiasis. Journal of Investigative Dermatology 1978, 70: 130–133.
Djawari, D., Bischoff, T., Hornstein, O. P. Impairment of chemotactic activity of microphages in chronic mucocutaneous candidosis. Archives of Dermatology Research 1978, 262: 247–253.
Drew, J. H. Chronic mucocutaneous candidiasis with abnormal function of serum complement. Medical Journal of Australia 1973, 2: 77–80.
Ray, T. L., Wuepper, K. D. Activation of the alternative (properdin) pathway of complement byCandida albicans and related species. Journal of Investigative Dermatology 1976, 67: 700–703.
Ray, T. L., Wuepper, K. D. Experimental cutaneous candidiasis in rodents. II: Role of the stratum corneum barrier and serum complement as a mediator of a protective inflammatory response. Archives of Dermatology 1978, 114: 539–543.
Gelfand, J. A., Hurley, D. L., Fauci, A. S., Frank, M. M. The role of complement in host defense against experimental disseminated candidiasis. Journal of Infectious Diseases 1978, 138: 9–16.
Valdimarsson, H., Higgs, J. M., Wells, R. S., Yamamura, M., Hobbs, J. R., Holt, P. J. L. Immune abnormalities associated with chronic mucocutaneous candidiasis. Cellular Immunology 1973, 6: 348–361.
Holt, P. J. L. Immunological disorders of chronic candidiasis. In: Brent, L., Holborow, J. (ed.): Progress in immunology II. Volume 4. North-Holland, Amsterdam, 1974, p. 368–370.
Paterson, P. Y., Semo, R., Blumenschein, G., Swelstad, J. Mucocutaneous candidiasis, anergy and a plasma inhibitor of cellular immunity: reversal with amphotericin B. Clinical and Experimental Immunology 1971, 9: 595–602.
Kirkpatrick, C. H., Smith, T. K. Chronic mucocutaneous candidiasis. Immunologic and antibiotic therapy. Annals of Internal Medicine 1974, 80: 310–320.
Fischer, A., Ballet, J.-J., Griscelli, C. Specific inhibition of in vitroCandida-induced lymphocyte proliferation by polysaccharide antigens present in the serum of patients with chronic mucocutaneous candidiasis. Journal of Clinical Investigation 1978, 62: 1005–1013.
Witkin, S. S., Yu, I. R., Ledger, W. J. Inhibition ofCandida albicans-induced lymphocyte proliferation by lymphocytes and sera from women with recurrent vaginitis. American Journal of Obstetrics and Gynecology 1983, 147: 809–811.
Sobel, J. D. Recurrent vulvovaginal candidiasis. A prospective study of the efficacy of maintenance ketoconazole therapy. New England Journal of Medicine 1986, 315: 1455–1458.
Lehner, T., Wilton, J. M. A., Ivanyi, I. Immuno-deficiencies in chronic mucocutaneous candidiasis. Immunology 1972, 22: 775–787.
Sohnle, P. G., Frank, M. M., Kirkpatrick, C. H. Deposition of complement components in the cutaneous lesions of chronic mucocutaneous candidiasis. Clinical Immunology and Immunopathology 1976, 5: 340–350.
Stiller, R. L., Bennett, J. E., Scholer, H. J., Wall, M., Polak, A., Stevens, D. A. Susceptibility to 5-fluorocytosine and prevalence of serotype in 402Candida albicans isolates from the United States. Antimicrobial Agents and Chemotherapy 1982, 22: 482–487.
Dismukes, W. E. Azole antifungal drugs: old and new. Annals of Internal Medicine 1988, 109: 177–179.
Cleveland, W. W., Fogel, B. J., Brown, W. T., Kay, H. E. M. Foetal thymus transplant in a case of Di George's syndrome. Lancet 1968, ii: 1211–1214.
Levy, R. L., Huang, S. W., Bach, M. L., Bach, F. H., Hong, R., Ammann, A. J., Bortin, M., Kay, H. E. M. Thymic transplantation in a case of chronic mucocutaneous candidiasis. Lancet 1971, ii: 898–900.
Ballow, M., Hyman, L. R. Combination immunotherapy in chronic mucocutaneous candidiasis. Synergism between transfer factor and fetal thymus tissue. Clinical Immunology and Immunopathology 1977, 8: 504–512.
Kirkpatrick, C. H., Ottesen, E. A., Smith, T. K., Wells, S. A., Burdick, J. F. Reconstitution of defective cellular immunity with foetal thymus and dialysable transfer factor. Long term studies in a patient with chronic mucocutaneous candidiasis. Clinical and Experimental Immunology 1976, 23: 414–428.
Wara, D. W., Ammann, A. J. Thymosin treatment of children with primary immunodeficiency disease. Transplantation Proceedings 1978, 10: 203–209.
Low, T. L. K., Goldstein, A. L. Thymosin and other thymic hormones and their synthetic analogues. Springer Seminars in Immunopathology 1979, 2: 169–186.
Molin, L., Bolla, K. Thymopentin in chronicTrichophyton rubrum infection. Survey of Immunology Research 1985, 4, Supplement 1: 135–138.
Goldstein, G., Scheid, M. P., Boyce, E. A., Schlesinger, D. H., Van Wauve, J. A synthetic pentapeptide with biological activity characteristic of the thymic hormone thymopoietin. Science 1979, 204: 1309–1310.
Kirkpatrick, C. H., Greenberg, L. E., Chapman, S. W., Goldstein, G., Lewis, V. M., Twomey, J. J. Plasma thymic hormone activity in patients with chronic mucocutaneous candidiasis. Clinical and Experimental Immunology 1978, 34: 311–317.
Valdimarsson, H., Moss, P. D., Holt, P. J. L., Hobbs, J. R. Treatment of chronic mucocutaneous candidiasis with leukocytes from HLA compatible sibling. Lancet 1972, i: 469–472.
Kirkpatrick, C. H., Rich, R. R., Graw, R. G., Smith, T. K., Mickenberg, I. D., Rogentine, G. N. Treatment of chronic mucocutaneous moniliasis by immunologic reconstitution. Clinical and Experimental Immunology 1971, 9: 733–748.
Sams, W. M., Jorizzo, J. L., Snyderman, R., Jegasothy, B. V., Ward, F. E., Wilson, J. G., Dillard, S. B. Chronic mucocutaneous candidiasis. Immunologic studies of three generations of a single family. American Journal of Medicine 1979, 67: 948–959.
Jorizzo, J. L., Sams, W. M., Jr., Jegasothy, B. V., Olansky, A. J. Cimetidine as an immunomodulator: chronic mucocutaneous candidiasis as a model. Annals of Internal Medicine 1980, 92: 192–195.
Kirkpatrick, C. H., Rich, R. R., Smith, T. K. Effect of transfer factor on lymphocyte function in anergic patients. Journal of Clinical Investigation 1972, 51: 2948–2958.
Kirkpatrick, C. H. Transfer factor. Journal of Allergy and Clinical Immunology 1988, 81: 803–813.
Kirkpatrick, C. H., Greenberg, L. E. Treatment of chronic mucocutaneous candidiasis with transfer factor. In: Kahn, A., Kirkpatrick, C. H., Hill, N. O. (ed.): Immune regulators in transfer factor. Academic Press, New York, 1979, p. 547–562.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kirkpatrick, C.H. Chronic mucocutaneous candidiasis. Eur. J. Clin. Microbiol. Infect. Dis. 8, 448–456 (1989). https://doi.org/10.1007/BF01964059
Issue Date:
DOI: https://doi.org/10.1007/BF01964059