Clinical presentation
Candidiasis affects the oral, vaginal and gastrointestinal tract mucosae. Oral candidiasis is the most common, usually presenting as white, exudative, mucosal plaques on the tongue, and oral mucosa. It can also present as the erythematous/atrophic erythematous form without white plaques which is often missed. Alternative presentations include angular cheilitis with erythema and white scale, and chronic hyperplastic candidiasis with discrete leukoplakia. In patients with oropharyngeal candidiasis, dysphagia should prompt a presumptive diagnosis of Candida esophagitis, and endoscopy is required for definitive diagnosis.[72] Recurrent episodes of vulvovaginal candidiasis (VVC) are also common in HIV. Symptoms of VVC are pruritus, dyspareunia and dysuria. The vulval component of the infection presents as a morbiliform rash with papulopustules that may extend to the thighs, and the vaginal infection is associated with white cheesy discharge, and plaques are seen on erythematous vaginal walls.[73]