Superficial candidiasis of the face in a healthy woman with strong induction of human beta defensin-2 expression and red
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obert FELDMANN Marlies WRUHS Alexander STELLA Andreas STEINER
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Superficial candidiasis of the face in a healthy woman with strong induction of human beta defensin-2 expression and reduction of Langerhans cells in the lesional epidermis Candida albicans is a frequent and normal commensal of the gastro-intestinal tract, oral cavity, and skin surface adjacent to body orifices, however, it may become a pathogen causing superficial candidiasis of the skin [1]. Both innate and adaptive immune responses are believed to be critical for the defence against Candida infections. Human beta defensin-2 (hBD-2) expression is induced in the epidermis in the early innate immune response to microbial challenge [2]. Of note, expression of hBD-2 is significantly impaired in congenital mucocutaneous canEJD, vol. 30, n◦ 4, July-August 2020
didiasis patients [3] and its animal model [4], suggesting critical roles for hBD-2 in the defence against candidiasis. Here, we report an otherwise healthy, middle-aged woman with facial candidiasis due to C. albicans, with investigation of hBD-2 and Langerhans cells (LCs) [2, 5]. Our results suggest that the reduction of lesional LCs may be related to development of candidiasis, whereas strong lesional expression of hBD-2 was neither dependent on the presence of LCs, nor sufficient to control infection in the present case. A 49-year-old woman was referred with scaly erythematous plaques on her face (figure 1A). The plaques began as acneiform papules on the right cheek. She then started to wear a face mask to cover facial lesions. The papules gradually enlarged into scaly erythematous plaques and spread to the left cheek. She was treated with topical corticosteroids and antibiotic lotion, but these were not effective. She was referred to our hospital. Her general health status was good and she had no history of previous fungal infection, diabetes mellitus, drug abuse, alcoholism, or immunosuppressive treatments or disorders. Complete blood count, blood chemistry and antinuclear antibodies were within normal
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