Mucocutaneous candidiasis or mucocutaneous microbiosis?

CHRONIC mucocutaneous candidiasis is a clinical syndrome characterized by chronic oral candidiasis (thrush), cutaneous candidiasis, and candidal nail involvement. Endocrine abnormalities are common. The syndrome may be familial or sporadic with onset in infancy or in adulthood.1 The case described represents a generally unappreciated variation in the syndrome—dermatophyte infection of the skin. Recognition of this variant has a considerable clinical relevance. This subgenus of the syndrome also suggests a different pathogenetic process than that presumed involved in chronic candidiasis. Report of a Case A 15-year-old boy has had lesions of the left eyelid, mouth, fingernails, and toenails since shortly after birth. The working diagnosis was candidiasis. Topically applied agents including tolnaftate, nystatin, and haloprogin had been given extensive trial with no benefit. Transfer factor equivalent to 1 × 108 cells was given four times with no clinical improvement. No family history of skin disease was elicited. Physical examination at