The aim of this study was to examine the effects and the sensitivity of antifungal therapy for patients with oral candidiasis and to investigate the relationship among the signs & symptoms of patients and the ratio change of Candida species to antifungal therapy. Candida fungus culture test with ChromeIDTM Candida agar (CAN2) was carried out more than twice for 10 patients who visited Oral Medicine department of Chonnam National University Dental Hospital during the period from Dec. 2015 to Aug. 2016. After culturing the smear sample before and after antifungal therapy in ChromeIDTM Candida agar (CAN2), the number of colonies was counted to compare. Patients were divided into 5 group according to the therapeutic effects of the antifungal agents used: 1) high susceptibility to nystatin, 2) low susceptibility to nystatin, 3) high susceptibility to fluzonazole, 4) low susceptibility to fluzonazole, and 5) increased ratio of new Candida species. Although nystatin is used as first-line therapy in oral candidiasis, it is desirable to use fluconazole if patients had a history of the low sensitivity to nystatin or chemotherapy. Even if the patient's symptoms and signs are improved, there is a possibility of oral candidiasis recurring, so that clinicians should be careful during the treatment with antifungal agents.

Chronic hyperplastic candidiasis (CHC) is characterized by epithelial hyperplasia of the oral mucosa associated with candidal hyphae. The immune status of host is one of the factors that induce clinically evident candidal infection. Host defense mechanisms include inflammatory cells, epithelial barrier, and antimicrobial peptides such as human beta 2 defensin (hBD-2). In the present study, we investigated the densities of CD4+/CD8+ T lymphocytes and hBD-2 expression of epithelial cells in CHC. Immunohistochemical staining was performed on 10 cases of CHC using CD4, CD8 and hBD-2. Ten specimens of chronic mucositis were selected for comparison, and went through the same examination. hBD-2 was expressed in the spinous cell layers and the keratin layers of 7 CHC patients, while the epithelium of chronic mucositis did not demonstrate the hBD-2 expression except for one case. Also, hBD-2 expression was stronger when the hyphae invaded the upper stratum spinosum (P =.019). However, the densities of CD8+ T lymphocytes were significantly lower in the CHC patients, suggesting that the ability of CD8+ T cells to enter the epithelium and target the pathogenic hyphae was decreased in CHC. Increased hBD-2 expression seemed to be significantly associated with the candidal infection, while not promoting the cell-mediated immune reaction in CHC.