Chronic Mucocutaneous Candidiasis (CMC)
CMC is characterized by persistent Candida (fungus) infections of the mucous membranes, scalp, skin and nails, but not of the blood stream or internal organs (i.e. not systemic candidiasis). CMC is usually congenital and often hereditary, with onset in infancy manifested by persistent oral Candida infections (thrush). Later, the nails and skin become chronically infected. These infections respond to anti-Candida treatment but recur when the treatment stops.
CMC is associated with a selective T-cell deficiency to Candida and a few related fungi, but otherwise their immune system is fine. The most common abnormal laboratory test is a negative delayed hypersensitivity skin test to Candida antigen despite widespread Candida infection.
One hereditary form of CMC is the APECED Syndrome (autosomal recessive polyendocrinopathy-candidiasis-ectodermal dysplasia) associated with multiple endocrine problems (eg hypothyroidism or Addison disease) due to an AIRE gene defect on chromosome 21. A few CMC patients develop severe hepatitis or bronchiectasis. Treatment requires life-long antifungal medicines.