Dental students

1. z
Erythematous
candidiasis
Govind deo kumar
4th year (BDS)

2. z
Erythematous Candidiasis
 The erythematous form of candidiasis was previously referred to
as atrophic oral candidiasis.
 An erythematous surface may not just reflect atrophy but can
also be explained by increased vascularization.
 The lesion has a diffuse border which differentiates it from
erythroplakia which usually has a demarcation And often appear
as slightly submerged lesion.
 It is mainly of two types acute & chronic

3. z Etiology
 The local prediposing factors are
 Smoking
 Denture wearing
 Topical steroids
 Atopic constitution
 Imbalance of oral microflora

4. z
 General predisposing factors are
 Immunosuppressive diseases
 Immunosuppresive drugs
 Endocrine disorder
 Heamtrinic deficiencies

5. z Clinical features
1 . This type of candidiasis is usually found on the dorsal surface of the
tongue or on the palate.
2. It is most frequently related to wearing of denture.
3. Patient complains of burning sensation .
4. Clinically., it is manifested as a painful localized erythematous area
and there is central papillary atrophy of the tongue
5. It is the only form of candidiasis associated with pain.
6. The lesions appear red (thus termed as red lesion) and sometimes
ulcerated.

6. z
Case Report
 A 62 year old male patient reported to the department with the
chief complaint of pain and redness in the upper arch while
wearing his denture since 1-2 years and therefore he came to
make a new denture.
History of present illlnes : A 62 year old male patient reported to
the department with the chief complaint of pain and redness in the
upper arch . Pain is dull and radiating in nature . Pain is also
recurrent in nature and patient feels pain only upon wearing the
denture. He is wearing his current denture since 2-3 years

7. z
 The patient did not have any medical history and drug history
and no history of hospitalization is reported.
 Past dental history : This is patient’s 3 rd visit to a dental
hospital. He made his upper maxillary denture in a dental clinic
in dehradun since 2-3 years back.

8. z
Periodontal and dentition examination
On periodontal examinationthe color of gingiva is reddish pink with
generalised melanin pigmentation and the position is apical to CEJ
w.r.t 43,44,45,33,36 and the contour is bulbous generalised and
consistency was edematous generalised
Bleeding on probing was present w. r. t 43,44,45,33,36 and
exudation was absent.
All upper maxillary teeth were absent and in the mandibular arch
43,44,45,33 and 36 were present.
Occlusal caries was present w.r.t 36 and 37

9. z

10. z
Intra oral examination
 On inspection red coloured nodular mucosa was present in the
central part of the hard and soft palate and on the ridge and the
shape of the lesion is irregular with well defined margins. The
extensions of the lesion is at the junction of hard and soft palate.
The surface of lesion is rough and the surrounding areas are
reddish with no bleeding
 On palpation there was no tenderness and the consistency was
edematous with smooth texture and is fixed to the surrounding
and it was nonn compressible
 The plane and depth of the lesion is superficial.

11. z Final diagnosis
 Chronic generalised marginal and pappilary gingivits
 Occlusal caries w.r.t 36,37
 Speckled leukoplakia
 Chronic erythematous candidiasis

12. z Treatment plan
 Emergency treatment : not required
 Phase 1 Non surgical : Scaling and polishing is advised
 Phase 2 Surgical phase : not required
 Phase 3 : Restorative phase : Gic restoration w.r.t 36,37
 Phase 4 : Maintenance phase : patient is advised not to wear his
current denture till he gets a new one.
 Patient is advised for tobbaco cessation counselling and is advised
to do proper brushing and cleaning of tongue to eliminate the debris
2 times a day .

13. z Prescription
 Rx Cap. Fluconazole 50-100 mg 1 cap daily (3-4 weeks)
 Candid mouthwash for topical application 3 times a day after
meals