HYPERPLASTIC CANDIDIASIS: A CLINICO-PATHOLOGICAL COMPARISON WITH LEUKOPLAKIA

Objectives: To investigate systemic and local factors associated with hyperplastic candidiasis in comparison with leukoplakia
Methods: Retrospective analysis, 2000-2013
Results: The study included 62 patients with microscopy proven hyperplastic candidiasis, 40 M: 22 F, mean age 58.8. The control consisted of 54 patients with leukoplakia without dysplasia, 32 M;22 F, mean age 53.7 years. The tongue and buccal mucosa were most frequently involved in both groups. In the candidiasis group, significantly less cases presented as white lesions ( p<0.0001), more were ulcerated or exophytic (p= 0.006, p=0.002). Head and neck malignancy was significantly more frequent in the candidiasis group (17.7% Vs.1.8%,), diagnosed prior to or after diagnosis of candidiasis. Immunological diseases were more frequently associated with candidiasis (8.1% Vs. 0%, p=0.03). Diabetes Mellitus was found in 20.9% in candidiasis, 11.1% in leukoplakia, however, only a trend towards significance,p=0.15. No differences found in the prevalence of ischemic heart disease, hypertension, osteoporosis, hyperlipidemia, non-H&N malignancy, lung disease. A total of 208 medications were recorded, more in the candidiasis group (mean 3.7) than in leukoplakia (1.9).Chemotherapy and radiotherapy were significantly more frequent in the candidiasis group. Smoking was equally prevalent in both groups (24.2%, 25.9%).
Conclusions: Hyperplastic candidiasis has a male predominance and a predisposition for tongue and buccal mucosa, similar to the profile of patients with leukoplakia. A higher prevalence of head and neck malignancy, radiation to the head and neck, chemotherapy and immunological diseases were associated with hyperplastic candidiasis, but only a trend towards higher prevalence of diabetes mellitus.