慢性皮肤黏膜念珠菌病的研究进展OA

Chronic mucocutaneous candidiasis(CMC)is an infectious phenotype characterized by recurrent or per-sistent infections caused by Candida species that affect the skin,nails,oral,and genital mucosae for a duration exceed-ing six months.Current research suggests that CMC is an immunodeficiency disease with a complex pathogenesis.Pa-tients with CMC have various defects in nonspecific and/or specific immunity against Candida infection,resulting in the inability of patients to defend themselves against Candida infection.CMC can be stratified into primary CMC and sec-ondary CMC based on etiology.Primary CMC is often associated with genetic mutations leading to immunodeficiencies in T helper cell 17 and interleukin-17,whereas secondary CMC is frequently linked to factors such as human immuno-deficiency virus infection,diabetes mellitus,and immunosuppressive therapy.Primary CMC typically manifests as Can-dida infections,with distinct genetic mutations often correlating to varied concomitant symptoms.Secondary CMC may present with not only superficial mucosal Candida infections and manifestations of the underlying primary disease but also with invasive fungal infections.Diagnosing CMC requires an integration of medical history and clinical presenta-tion,supplemented by the outcomes of auxiliary diagnostic procedures,including microscopic examination of fungal smear,fungal culture,immunological testing,and genetic sequencing and analysis.Furthermore,confirming primary CMC requires exclusion of the aforementioned secondary factors.At present,antifungal drugs such as triazoles,echino-candins,and polyenes are the main treatment for CMC.Moreover,immunotherapy with biologics such as Janus kinase(JAK)inhibitors provides more options for the clinical treatment of patients with CMC.Gene therapy also has potential clinical application value.In this review,we discuss the etiologies,pathogenesis,clinical manifestations,diagnosis,and treatments of CMC,aiming to provide a reference for the clinical diagnosis and treatment of CMC.