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Hyperplastic candidiasis

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Q&A: Could oral candidal infections induce dysplastic lesions in the oral cavity?

Author: Sanketh DS, MDS

Candidal infections could sometimes induce a hyperplastic tissue response manifesting as a white lesion that cannot be rubbed off. Such lesions are termed “hyperplastic candidiasis” and are also called “candidal leukoplakia” or “candida associated leukoplakia”. Some researchers doubt this condition could arise as a result of candida and believe it to be a candidal infection superimposed on a pre-existing leukoplakic lesion. However, there are reports that state candidal organisms could induce hyperplasia and cause hyperkeratotic white lesions.

Hyperplastic candidiasis commonly occurs on the retro-commissural areas and less often on the tongue and lips. They are raised, plaque like white lesions which may be homogenous or speckled.

A biopsy of the lesion is important as, apart from being hyperplastic, could also show varying degrees of dysplasia. It is reported to have a higher risk of malignant transformation than conventional leukoplakias.

Research shows a positive association of candida with dysplasia and also report certain strains of candida albicans could induce neoplastic transformation.

Although clouded in controversy, some pathologists and investigators believe hyperplastic candidiasis could cause dyplastic leukoplakic lesions and regard them as being potentially malignant.

REFERENCES

Shafer’s Textbook of Oral Pathology. Rajendran and Sivapathasundaram.6th Edition.

Oral and Maxillofacial Pathology.Neville,Damm,Allen,Chi. South Asian Edition.

Oral Pathology: Clinicopathologic correlations.Regezzi,Sciubba,Jorda.5th Edition.

Scully C, el-Kabir M, Samaranayake LP. Candida and oral candidosis: a review. Crit Rev Oral Biol Med. 1994;5(2):125-57.

Sanketh DS, Patil S, Rao RS. Estimating the frequency of Candida in oral squamous cell carcinoma using Calcofluor White fluorescent stain. J Investig Clin Dent. 2016;7(3):304-7.

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