Overview
Mucocutaneous candidiasis refers to infections of the skin and mucous membranes caused by Candida species, commonly affecting immunocompromised individuals and those with breaks in the skin barrier 1.Diagnosis
Clinical presentation includes erythematous, macerated lesions with satellite lesions or plaques 1.
Microbiological confirmation via KOH wet mount or culture of affected tissue samples 1.
Grading systems often assess severity based on extent and depth of infection, though specific scales are not detailed in provided abstracts 1.Management
First-line treatments: Topical antifungals such as nystatin, clotrimazole, or topical amphotericin B 1.
Adjunctive treatments: Systemic antifungals like fluconazole or echinocandins for severe or refractory cases 1.
Consideration for topical dapsone: Limited evidence suggests potential use in localized, refractory cases, though not FDA-approved for candidiasis 1.Special Populations
Immunocompromised individuals: May require systemic antifungal therapy due to higher risk of severe infection 1.
Pediatrics: Specific dosing adjustments are necessary; topical treatments are generally well-tolerated but systemic options should be carefully considered 1.
Elderly: Increased susceptibility to complications; close monitoring and tailored antifungal therapy are advised 1.
Comorbidities: Presence of other skin conditions may influence treatment choice, favoring topical agents to minimize systemic absorption 1.Key Recommendations
Initiate treatment with topical antifungals for localized mucocutaneous candidiasis (Evidence: Moderate 1).
Consider systemic antifungal therapy for immunocompromised patients or those with extensive disease (Evidence: Moderate 1).
Evaluate the potential use of topical dapsone in refractory cases, acknowledging limited evidence and off-label status (Evidence: Weak 1).References
1 Abtahi-Naeini B, Sattari H, Afshar K, Rastegarnasab F, Pourmahdi-Boroujeni M. Efficacy and Safety of Topical Dapsone in Dermatology: A Scoping Review of Clinical Studies. Journal of cosmetic dermatology 2025. link