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Chronic Mucocutaneous Candidosis: Title and subTitle BreakAn Update

Joseph L. Jorizzo, MD
[+] Author Affiliations

Galveston, Tex


Arch Dermatol. 1982;118(12):963-965. doi:10.1001/archderm.1982.01650240007010
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Chronic mucocutaneous candidosis (CMC) is an uncommon superficial candidal infection of the skin, nails, and oral and genital mucosa. Clinically, it is typified by the onset, usually within the first year of life, of chronic, occasionally granulomatous, candidal infections.1 Persistent oral thrush with subsequent hypertrophic changes, vulvovaginal infection, cutaneous lesions—sometimes severely hyperkeratotic and affecting preponderantly the intertriginous sites but often involving the trunk, limbs, and scalp, and parenchymal involvement with accompanying nail dystrophy—are all typical clinical features of CMC. Frequently, concomitant dermatophyte infections are present.2 Traditional anticandidal and antifungal therapies are ineffective.

Chronic mucocutaneous candidosis is not a single disease entity but rather a final common pathway for multiple predisposing abnormalities of the immune system that ranges from severe, life-threatening immunodeficiency syndromes to subtle deficiencies, usually of cell-mediated immunity.3 Many subgroups of CMC have been reported with pleomorphism of inheritance patterns, immunodeficiency states, and associated medical conditions.3

REFERENCES

Kirkpatrick CH, Rich RR, Bennett JE:  Chronic mucocutaneous candidiasis: Model-building in cellular immunity . Ann Intern Med 1971;;74:955-978.
Shama SK, Kirkpatrick CH:  Dermatophytosis in patients with chronic mucocutaneous candidiasis . J Am Acad Dermatol 1980;;2:285-294.
Sams WM Jr, Jorizzo JL, Snyderman R, et al:  Chronic mucocutaneous candidiasis: Immunologic studies of three generations of a single family . Am J Med 1979;;67:948-958.
DeVillez RL, Lewis CW:  Candidiasis seminar . Cutis 1977;;19:69-83.
Edwards JE Jr, Lehrer RI, Stiehm ER, et al:  Severe candidal infections: Clinical perspective, immune defense mechanisms and current concepts of therapy . Ann Intern Med 1978;;89:91-106.
Dudley JP, Kobayashi R, Rosenblatt HM, et al:  Candida laryngitis in chronic mucocutaneous candidiasis: Its association with Candida esophagitis . Ann Otol Rhinol Laryngol 1980;;89:574-575.
Ray TL, Wuepper KD:  Recent advances in cutaneous candidiasis . Int J Dermatol 1978;;17:683-690.
Rogers TJ, Balish E:  Immunity to Candida albicans . Microbiol Rev 1980;;44:660-682.
Wilborn WH, Montes LP:  Scanning electron microscopy of oral lesions in chronic mucocutaneous candidiasis . JAMA 1980;;244:2294-2297.
Dahl MV:  Primary immunodeficiency disease: Evaluation and cutaneous manifestations . Dermatol Digest 1978;;17:31-45.
osGosseye S, Nezelof C:  T system immunodeficiencies in infancy and childhood . Pathol Res Pract 1981;;171:142-158.
Lehner T, Wilton JMA, Ivanyi L:  Immunodeficiencies in chronic mucocutaneous candidosis . J Immunol 1972;;22:775-787.
Littman BH, Rocklin RE, Parkman R, et al:  Transfer factor treatment of chronic mucocutaneous candidiasis: Requirement for donor reactivity to Candida antigen . Clin Immunol Immunopathol 1978;;9:97-110.
Walker SM, Urbaniak SJ:  A serum-dependent defect of neutrophil function in chronic mucocutaneous candidiasis . J Clin Pathol 1980;;33:370-372.
Bortolussi R, Faulkner G, Lee SHS, et al:  Phagocytosis of Candida albicans in chronic mucocutaneous candidiasis . Pediatr Res 1981;;15:1287-1292.
Hertz KC, Gazze LA, Kirkpatrick CH, et al:  Autoimmune vitiligo: Detection of antibodies to melanin-producing cells . N Engl J Med 1977;;297:634-637.
Betterle C, Peserico A, Bersani G:  Vitiligo and autoimmune polyendocrine deficiencies with autoantibodies to melanin-producing cells . Arch Dermatol 1979;;115:364.
Howanitz N, Nordlund JL, Lerner AB, et al:  Autoantibodies to melanocytes: Occurrence in patients with vitiligo and chronic mucocutaneous candidiasis . Arch Dermatol 1981;;117:705-708.
Higgs JM, Wells RS:  Chronic mucocutaneous candidiasis: Associated abnormalities of iron metabolism . Br J Dermatol 1972;;86( (suppl) ):88-102.
Kirkpatrick CH, Windhorst DB:  Mucocutaneous candidiasis and thymoma . Am J Med 1979;;66:939-945.
 Management of chronic mucocutaneous candidosis . Clin Exp Dermatol 1981;;6:515-519.
Rockoff AS:  Chronic mucocutaneous candidiasis: Successful treatment with intermittent oral doses of clotrimazole . Arch Dermatol 1979;;115:322-323.
Medoff G, Dismukes WE, Meade RH, et al:  A new therapeutic approach to Candida infections . Arch Intern Med 1972;;130:241-245.
Hogan NA, Hill HR:  Enhancement of neutrophil chemotaxis and alteration of levels of cellular cyclic nucleotides by levamisole . J Infect Dis 1978;;138:437-444.
Akhter J, Merker RI, Rieger CHL, et al:  Effects of thymosin on lymphocytes from patients with chronic mucocutaneous candidiasis and endocrinopathies . J Allergy Clin Immunol 1980;;65:34-40.
Jorizzo JL, Sams WM Jr, Jegasothy BV, et al:  Cimetidine as an immunomodulator: Chronic mucocutaneous candidiasis as a model . Ann Intern Med 1980;;92:192-195.
Petersen EA, Ailing DW, Kirkpatrick CH:  Treatment of chronic mucocutaneous candidiasis with ketoconazole: A controlled clinical trial . Ann Intern Med 1980;;93:791-795.
Graybill JR, Herndon JH Jr, Knicker WT, et al:  Ketoconazole treatment of chronic mucocutaneous candidiasis . Arch Dermatol 1980;;116:1137-1141.
Dwyer JM:  Chronic mucocutaneous candidiasis . Ann Rev Med 1981;;32:491-497.

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Kirkpatrick CH, Rich RR, Bennett JE:  Chronic mucocutaneous candidiasis: Model-building in cellular immunity . Ann Intern Med 1971;;74:955-978.
Shama SK, Kirkpatrick CH:  Dermatophytosis in patients with chronic mucocutaneous candidiasis . J Am Acad Dermatol 1980;;2:285-294.
Sams WM Jr, Jorizzo JL, Snyderman R, et al:  Chronic mucocutaneous candidiasis: Immunologic studies of three generations of a single family . Am J Med 1979;;67:948-958.
DeVillez RL, Lewis CW:  Candidiasis seminar . Cutis 1977;;19:69-83.
Edwards JE Jr, Lehrer RI, Stiehm ER, et al:  Severe candidal infections: Clinical perspective, immune defense mechanisms and current concepts of therapy . Ann Intern Med 1978;;89:91-106.
Dudley JP, Kobayashi R, Rosenblatt HM, et al:  Candida laryngitis in chronic mucocutaneous candidiasis: Its association with Candida esophagitis . Ann Otol Rhinol Laryngol 1980;;89:574-575.
Ray TL, Wuepper KD:  Recent advances in cutaneous candidiasis . Int J Dermatol 1978;;17:683-690.
Rogers TJ, Balish E:  Immunity to Candida albicans . Microbiol Rev 1980;;44:660-682.
Wilborn WH, Montes LP:  Scanning electron microscopy of oral lesions in chronic mucocutaneous candidiasis . JAMA 1980;;244:2294-2297.
Dahl MV:  Primary immunodeficiency disease: Evaluation and cutaneous manifestations . Dermatol Digest 1978;;17:31-45.
osGosseye S, Nezelof C:  T system immunodeficiencies in infancy and childhood . Pathol Res Pract 1981;;171:142-158.
Lehner T, Wilton JMA, Ivanyi L:  Immunodeficiencies in chronic mucocutaneous candidosis . J Immunol 1972;;22:775-787.
Littman BH, Rocklin RE, Parkman R, et al:  Transfer factor treatment of chronic mucocutaneous candidiasis: Requirement for donor reactivity to Candida antigen . Clin Immunol Immunopathol 1978;;9:97-110.
Walker SM, Urbaniak SJ:  A serum-dependent defect of neutrophil function in chronic mucocutaneous candidiasis . J Clin Pathol 1980;;33:370-372.
Bortolussi R, Faulkner G, Lee SHS, et al:  Phagocytosis of Candida albicans in chronic mucocutaneous candidiasis . Pediatr Res 1981;;15:1287-1292.
Hertz KC, Gazze LA, Kirkpatrick CH, et al:  Autoimmune vitiligo: Detection of antibodies to melanin-producing cells . N Engl J Med 1977;;297:634-637.
Betterle C, Peserico A, Bersani G:  Vitiligo and autoimmune polyendocrine deficiencies with autoantibodies to melanin-producing cells . Arch Dermatol 1979;;115:364.
Howanitz N, Nordlund JL, Lerner AB, et al:  Autoantibodies to melanocytes: Occurrence in patients with vitiligo and chronic mucocutaneous candidiasis . Arch Dermatol 1981;;117:705-708.
Higgs JM, Wells RS:  Chronic mucocutaneous candidiasis: Associated abnormalities of iron metabolism . Br J Dermatol 1972;;86( (suppl) ):88-102.
Kirkpatrick CH, Windhorst DB:  Mucocutaneous candidiasis and thymoma . Am J Med 1979;;66:939-945.
 Management of chronic mucocutaneous candidosis . Clin Exp Dermatol 1981;;6:515-519.
Rockoff AS:  Chronic mucocutaneous candidiasis: Successful treatment with intermittent oral doses of clotrimazole . Arch Dermatol 1979;;115:322-323.
Medoff G, Dismukes WE, Meade RH, et al:  A new therapeutic approach to Candida infections . Arch Intern Med 1972;;130:241-245.
Hogan NA, Hill HR:  Enhancement of neutrophil chemotaxis and alteration of levels of cellular cyclic nucleotides by levamisole . J Infect Dis 1978;;138:437-444.
Akhter J, Merker RI, Rieger CHL, et al:  Effects of thymosin on lymphocytes from patients with chronic mucocutaneous candidiasis and endocrinopathies . J Allergy Clin Immunol 1980;;65:34-40.
Jorizzo JL, Sams WM Jr, Jegasothy BV, et al:  Cimetidine as an immunomodulator: Chronic mucocutaneous candidiasis as a model . Ann Intern Med 1980;;92:192-195.
Petersen EA, Ailing DW, Kirkpatrick CH:  Treatment of chronic mucocutaneous candidiasis with ketoconazole: A controlled clinical trial . Ann Intern Med 1980;;93:791-795.
Graybill JR, Herndon JH Jr, Knicker WT, et al:  Ketoconazole treatment of chronic mucocutaneous candidiasis . Arch Dermatol 1980;;116:1137-1141.
Dwyer JM:  Chronic mucocutaneous candidiasis . Ann Rev Med 1981;;32:491-497.

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