ORAL CANDIDOSIS AND CARCINOMA

SUMMARY.— Three cases of chronic oral candidosis are presented. In 2 of these malignant change eventually occurred, as confirmed on repeated biopsy examination. The early diagnosis and active treatment of chronic localized candidal infection in the mouth is important as there appears to be a definite propensity for malignant change.     

IATROGENIC ORAL CANDIDOSIS

SUMMARY.— Two distinct varieties of iatrogenic oral candidosis can be induced by topical application of drugs. Acute pseudomembranous candidosis developed with topical betamethasone-17-valerate, in the presence of significant titres of IgG, IgA and IgM class of Candida antibodies before infection, and without a change in the plasma cortisol level, in 23% of patients. This side effect was not observed with hydrocortisone hemisuccinate and betamethasone disodium phosphate, but was found in 1 of 17 patients using triamcinolone in orabase. Topical tetracycline induced acute atrophic candidosis, in the absence of significant Candida antibody levels before infection, in 64% of patients. In acute pseudomembranous candidosis there was a further rise in titre of IgG and IgA type of Candida antibodies, but predominantly IgG class of antibodies rose to low levels during the acute atrophic infection.     

EXPERIMENTALLY INDUCED ACUTE ORAL CANDIDOSIS IN THE RAT

SUMMARY.– The Wistar rat has been shown to be a suitable experimental animal in a model for the study of oral candidosis. The micro-organisms penetrated the stratum corneum of the tongue and buccal mucosa producing lesions resembling those in acute oral candidosis in humans. Salivary flow as varied in this experiment does not appear to be important in the genesis of this infection.     

MYCOSIS FUNGOIOES: ITS MANAGEMENT WITH SUPERFICIAL X-RAYS AND STRONTIUM 90 THERAPY COMPARED

Summary.— The natural history of mycosis fungoides (MF) in 21 patients is noted and discussed with particular reference to the response to therapy with superficial x-rays (16 patients) and beta rays from a Strontium 90 source (5 patients).
Useful palliation, which is not related to the duration of the disease, is obtained with either treatment but the convenience and safety of Strontium 90 make this form of treatment preferable to superficial x-rays.
It is suggested that beta ray therapy from a Strontium 90 source is the treatment of choice for MF presenting as excessive pruritus, widespread erythema and lichenification, exfoliation or as palmar and plantar byperkeratosis.     

SUPERFICIAL MYCOSES IN SAUDI ARABIA

Between June 1988 and December 1990, 1018 cases of superficial mycoses were investigated. Diagnosis was confirmed by microscopic examination in 503 cases and the causal agent was isolated in 490 cases. Tinea capitis accounted for 47.7% (92.5% in children below 10 years of age). The frequency of other clinical types in descending order was pityriasis versicolor 25.8%, tinea corporis 9%, onychomycosis 5.8%, tinea pedis 4%, intertrigo 3.9% and tinea cruris 2.8%. Erythrasma was encountered three times and mixed piedra and trichomycosis axillaris once. Microsporum canis was the commonest aetiological agent, responsible for 46.9% of ringworm infections. Malassezia furfur was the next most common agent (26.5%) followed by Candida albicans (8.6%) and Trichophyton violaceum (8.2%). Other species were found less frequently. T.simii was isolated from four cases of tinea cruris and one each of tinea capitis and tinea corporis, and Piedraia hortae and Trichosporon beigelii from a case of mixed piedra infection.     

THE NATURAL HISTORY OF PARAPSORIASIS EN PLAQUES (CHRONIC SUPERFICIAL DERMATITIS) AND PRERETICULOTIC POIKILODERMA

The term parapsoriasis en plaques includes 2 quite unrelated conditions, one eczematous and benign, the other prereticulotic and potentially malignant. These 2 conditions are described and their features are compared in detail. In England, especially the south, the benign form is a good deal more common than the premalignant. The reason why parapsoriasis en plaques is regarded as a potentially serious disease is thus due largely to nomenclature, but also in part to the fact that, in the early stages of the classical Alibert form of mycosis fungoides and in prereticulotic poikiloderma, the appearances can closely simulate the benign type of parapsoriasis. Careful clinical observation and histological examination should, however, serve to distinguish between them.