RESUMO
Mucosal yeast infection is best understood as a consequence of compromised mucosal cell-mediated and innate immunity. Defense against oral candidiasis is dominantly cell mediated. The innate immune system may play the main role in regulating vulvovaginal yeast infection. Conditions that compromise cell-mediated immunity such as leukemia, severe illness and HIV infection must be considered as predisposing factors for recurrent oral candidiasis. Compromise of vaginal innate immunity due to mucosal allergy or due to a genetic defect such as mannose-binding lectin deficiency contributes to chronic vulvovaginal yeast infection. Treatment of cofactors must be considered in order to achieve control in recurrent mucosal yeast infection.
Assuntos
Antifúngicos/administração & dosagem , Mucosite/tratamento farmacológico , Micoses/tratamento farmacológico , Administração Intravaginal , Administração Tópica , Antifúngicos/efeitos adversos , Candidíase Bucal/tratamento farmacológico , Candidíase Bucal/etiologia , Candidíase Vulvovaginal/tratamento farmacológico , Candidíase Vulvovaginal/etiologia , Feminino , Humanos , Imunidade Inata , Mucosite/etiologia , Mucosite/fisiopatologia , Micoses/etiologia , Micoses/fisiopatologia , Recidiva , Fatores de Risco , Dermatopatias Papuloescamosas/complicaçõesRESUMO
Ever since the pH of the vagina was found to be much more acidic than blood and interstitial fluids, a belief going back more than a century has persisted that the vagina is protected from pathogenic organisms by the high level of hydronium ions present. A corollary of this belief is that the pH of the vagina and antipathogen activity is due to colonizing Lactobacilli. Unfortunately, this dogma lacks empirical research support. The vaginal pH is determined by the interplay between vaginal physiological processes and microbiology. An acidic vaginal pH and Lactobacilli are components of multiple defense mechanisms active in protection against infection in the lower female genital tract.
Assuntos
Lactobacillus/fisiologia , Vagina/microbiologia , Epitélio/microbiologia , Epitélio/fisiologia , Feminino , Humanos , Concentração de Íons de Hidrogênio , Vagina/fisiologiaRESUMO
Aging and estrogen deficiency compromise the skin barrier's defense mechanisms, resulting in greater microbial colonization of the skin. Susceptibility to mechanical injury and chemical irritation also increases. Menopause blunts the cell-mediated immune response to microbes and allergens. Healing after an insult is delayed. Skin disorders such as lichen sclerosus or allergic dermatitis may not be clinically obvious. A biopsy interpreted by a dermatopathologist is often helpful. Some conditions require long-term use of topical steroid ointments, and antimicrobial therapy. A compounding pharmacist may be necessary to find a base for the topical cream that does not irritate.
