Clinico-Pathological & Cytological Evaluation of Oral Candidiasis: A Cross-Sectional Study

Background Oral candidiasis is a prevalent opportunistic fungal infection of the oral cavity, primarily induced by Candida albicans. It manifests with diverse clinical presentations and is often linked to underlying systemic or localised predisposing factors. For good management, it is very important to get an early and correct diagnosis. Exfoliative cytology, in conjunction with specialised staining methods, has developed into a valuable diagnostic tool. Aim To examine the distribution of oral candidiasis detected by exfoliative cytology based on clinical symptoms, sex, location, and age. Examined and explored are clinical, cytological, histological, and complex disorders related to oral candidiasis as well as the usefulness of cytology as a diagnostic tool. Materials & Methods This cross-sectional study was conducted among 1195 patients in the department of oral pathology & oral medicine & radiology, Saraswati Danwantari Dental College & Hospital Parbhani among patients diagnosed with oral candidiasis through exfoliative cytology method during the study period of one year (2019-2020). Cytological smears were collected and examined utilising Papanicolaou (Pap) stain and Periodic Acid-Schiff (PAS) staining for the identification of Candida species. Cases exhibiting solely spores were subsequently validated through culture. In certain instances, histopathological analysis was conducted subsequent to antifungal treatment. The data were examined according to age, sex, clinical presentation, lesion location, cytological results, and histopathological correlation. Results There were 1195 people in the study, with a slight majority of men (51.0%) and women making up 49.0% of the group. Most of the people who took part (35.1%) were between the ages of 41 and 60. Based on exfoliative cytology, 33.0% of the cases had oral candidiasis, while 67.0% did not. Pseudomembranous candidiasis was the most common clinical type among the cytologically confirmed cases (40.1%), followed by erythematous (25.9%), hyperplastic (14.0%), erosive (10.9%), and mixed forms (9.1%). The tongue was the most commonly affected site, with 36.0% of cases. Cytological analysis indicated that mixed fungal forms were the predominant type (34.0%), succeeded by pseudohyphae (29.9%), solitary spores (20.1%), and mycelial forms (16.0%). Histopathological analysis revealed that hyperkeratosis was the predominant diagnosis (33.6%), succeeded by dysplasia (22.4%), lichen planus (17.8%), and various other lesions (24.3%), whereas malignancy was detected in a minor percentage of cases (1.9%). Most of the patients (50.3%) were treated with topical antifungal therapy. Conclusion Exfoliative cytology with PAS staining is a simple, reliable, and minimally invasive diagnostic tool for the detection of oral candidiasis. Its use in routine clinical practice can facilitate early diagnosis and prompt management, thereby reducing disease-related complications