A clinico-pathological and cytological study of oral candidiasis

Kayo Kuyama, Yan Sun, Chieko Taguchi, Hiroyasu Endo, Masanobu Wakami, Masahiko Fukumoto, Takanori Ito, Hirotsugu Yamamoto

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DOI: 10.4236/ojst.2011.14033                

Abstract

Candidiasis of the oral mucosa arises chiefly as a re- sult of infection with Candida albicans. Many clinico- pathological analyses of macroscopic findings have been described, although the clinical findings of oral candidiasis vary considerably and the conditions are complex. The present study analyzes the distribution, clinical, cytological and histological diagnoses of oral candidiasis, associated complex diseases and the di-agnostic value of cytology. The ratio of Candida in-fection was 28.9% among 1551 study participants. Females were infected significantly more often than men (p < 0.01) and the affected age range was 60 - 79 years (61.0%, p < 0.01). The predominantly affected areas were the tongue (48.3%, p < 0.01) and gingiva (20.0%, p < 0.01), and occurrence at multiple loci was seen in 43 (9.6%) patients. The typical clinical find- ings of oral candidiasis were ulcerative/erythematous lesions (33.2%, p < 0.01) and pseudomembranous candidiasis (31.6%, p < 0.01). A histopathological dia- gnosis of candidiasis based on biopsy specimens from 26 lesions in patients with Candida infection indicated by cytology was confirmed from cultures. The break- down of a cytological to a definite diagnosis was 6 positive (SCC 4, verrucous carcinoma 1, moderate to severe dysplasia 1), 6 suspected positive (mild dyspla- sia, 2; moderate to severe dysplasia, 2; papilloma, 1 and SCC, 1) and 14 negative (epulis, 3; papilloma, 3; granulation tissue, 2; fibrosis, 2 and others, 4). Exfo-liative cytology can easily judge the presence of Can-dida species, although experience is necessary for the presumptive diagnosis of an oral mucosal disease. The application of exfoliative cytology using the Pe- riodic acid-Schiff reaction is helpful for the earlier detection of oral candidiasis with various macrosco- pic findings.

Keywords

Candidiasis; Oral Exfoliative Cytology; Clinico-Pathology

Conflicts of Interest

The authors declare no conflicts of interest.

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