Candida albicans is a saprophytic organism that frequently resides in the mouth, skin, gastrointestinal and vaginal mucosa. It is also an opportunistic pathogen in immune compromised individuals, alcoholics, and debilitated subjects treated with antibiotics, steroids, or antineoplastic drugs. Although the most common site of gastrointestinal involvement is the esophagus, gastric candidiasis may occur in immune suppressed patients and is rarely apparent in healthy individuals. Symptoms are nonspecific; indigestion, abdominal pain, fever and weight loss have been described. The diagnosis can usually be established by visualizing yeast and/or mycelial forms in endoscopic biopsy or in mucosal brushings of the lesions. A case of gastric candidiasis presented with bleeding was experienced in a 69-year-old female with chronic renal failure due to diabetic nephropathy. She underwent orthopedic surgery because of intertrochanteric fracture of her femur. On the 6th day of the postoperative period, the patient began suffering from a large amount of melena. Endoscopic findings revealed multiple whitish or central necrotic plaques in the body and antrum of the stomach. Endoscopic biopsy revealed budding yeast and pseudohyphae infiltrating through the ulcerated stomach wall. After the patient was treated with mycostatin for 7 days, endoscopic and pathologic findings did not show any evidence of the candidiasis. The case is herein reported of gastric candidiasis presented with gastric bleeding, along with a review of corresponding literature.
Abdominal Pain ; Aged ; Alcoholics ; Anti-Bacterial Agents ; Antineoplastic Agents ; Biopsy ; Candida albicans ; Candidiasis* ; Diabetic Nephropathies ; Diagnosis ; Dyspepsia ; Esophagus ; Female ; Femur ; Fever ; Hemorrhage* ; Humans ; Kidney Failure, Chronic ; Melena ; Mouth ; Mucous Membrane ; Nystatin ; Orthopedics ; Postoperative Period ; Saccharomycetales ; Skin ; Steroids ; Stomach ; Ulcer ; Weight Loss ; Yeasts

BACKGROUND: Rosacea is characterized by erythema of the central face that persists for several months or longer. Reports of the histological changes in rosacea are scarce, and few attempts have been made to correlate such changes with clinical findings and pathophysiology. OBJECTIVE: This study aimed to elucidate the clinical manifestations of rosacea and investigate its histological features. METHODS: We performed a retrospective analysis of 278 patients with histologically confirmed rosacea who visited the Department of Dermatology at the Catholic Medical Center between January 2008 and May 2013. Clinical subtypes, disease severity, and precipitating factors were evaluated. In 115 randomly selected patients, histopathological features were evaluated as well. RESULTS: The ratio of males to females was 1:1.8. The age distribution showed a peak incidence in the fifth decade. The most common subtype was papulopustular rosacea (52.9%) followed by erythematotelangiectatic rosacea (34.9%), ocular rosacea (4.0%), and phymatous rosacea (2.9%). Granulomatous rosacea accounted for 5.4% of rosacea cases. Precipitating factors included hot weather (54.7%), stress (51.8%), sun exposure (37.4%), alcohol (37.4%), and hot baths (33.1%). Histological analysis of skin biopsies from 115 patients revealed solar elastosis in 62 patients (53.9%) and telangiectasia in 85 patients (73.9%). CONCLUSION: In this study, Korean rosacea patients were predominantly female with a peak age in the fifth decade and the majority suffered from the papulopustular and erythematotelangiectatic types of rosacea. Histological observations pertaining to each rosacea type were also discussed.
Age Distribution ; Baths ; Biopsy ; Dermatology ; Erythema ; Female ; Humans ; Incidence ; Korea ; Male ; Precipitating Factors ; Retrospective Studies ; Rosacea* ; Skin ; Solar System ; Telangiectasis ; Weather