Chronic mucocutaneous candidiasis in a child.

On examination, he had white adherent plaques of thrush and angular cheilitis [Figures 1A and 1B]. His nails were markedly thickened, fragmented, and discolored [Figure 2A]. He also had skin lesions characterized by erythematous, hyperkeratotic, serpiginous plaques over arms [Figure 2B] and scarring alopecia. His investigations revealed hemoglobin of 14.4 gm%, total WBC count 7800cells/mm and differential count N 69%, L 24%, M 7%. His random blood sugar, liver function tests, thyroid function tests, serum immunoglobulin, antinuclear antibodies, serum calcium and phosphorus were within normal limits. Culture from nail, hair, skin scrapings all grew candida albicans. His DNCB sensitization test was negative. He was diagnosed to have chronic mucocutaneous candidiasis based on clinical features and investigations. CD4 and CD8 cell counts were advised but not done. He improved with oral fluconazole and was advised to review after 3 months.