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Year : 2015  |  Volume : 16  |  Issue : 3  |  Page : 159-162

Successful treatment of chronic mucocutaneous candidiasis with oral antifungals and levamisole

1 Department of Dermatology, S.T.D. and Leprosy, Dr. RML Hospital, New Delhi, India
2 Department of Dermatology, Venereology and Leprology, Maulana Azad Medical College, New Delhi, India

Correspondence Address:
Surabhi Sinha
C 403, Sabka Ghar C.G.H.S., Plot No. 23, Sector 6, Dwarka, New Delhi - 110 075
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Source of Support: Nil., Conflict of Interest: There are no conflicts of interest.

DOI: 10.4103/2319-7250.160655

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Chronic mucocutaneous candidiasis is a group of diseases in which patients have recurrent or persistent infections of the skin, nails or mucosae, caused by Candida, most commonly by Candida albicans. These patients may also develop noncandidal infections, mostly dermatophytoses and viral infections of the skin. Treatment of this condition is a dilemma as there is no sustained improvement on antifungals alone. This is attributable to the basic cause of the syndrome, which is a primary defect in the cellular immunity of skin. Three siblings, born out of a nonconsanguineous marriage, presented with persistent candidal infections since early childhood and had never been completely lesion-free. Two of them also had lesions of molluscum contagiosum and scarring reminiscent of herpes zoster infection. They were started on azole antifungal therapy, but they continued to develop recurrent skin and oral lesions over the next 3 months. Levamisole was then added as an immunomodulator and a sustained remission was observed over a follow-up period of 6 months. The addition of levamisole to the antifungal drugs led to a sustained clinical improvement which was maintained over the next 6 months. This suggests immunomodulators like levamisole could be a useful adjunct in such patients and their role needs to be investigated in larger trials.

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