Chronic Hyperplastic Candidosis
This 60 year old female was referred by her dentist having noticed this white patch on the dorsum of the tongue. History dates back to over 2 years when a previous dentist also had commented about the appearance of her tongue. No symptoms were noted by the patient who had smoked 10+ cigarettes a day for over 40 years. The clinical appearance of this white patch with surrounding erythema and its anatomic location suggests this is chronic hyperplastic candidosis.
Notes: Chronic hyperplastic candidosis falls under a sub group of oral leukoplakia. Its malignant potential is not described in exact terms but the presence of chronic inflammation add to the risk. In a tissue biopsy the candida hyphae can be visualised by special stains, which gives weight to the diagnosis. Pathologists to not favour grading the dysplasia in the presence of chronic inflammation. The management includes treatment with antifungals, smoking cessation and if persistent excision. Several courses of antifungals would be needed to eradicate candida colonization.
[Photo supplied by Prof S. Warnakulasuriya]