Chronic Hyperplastic Candidiasis — MFDS Part 1 MCQ
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Correct answer: B — It is regarded as potentially malignant, so specialist assessment and diagnostic biopsy are required
Explanation lettering: D = shown as A · A = shown as B · B = shown as C · C = shown as D
A is correct. The fixed, non-wipeable raised plaque is characteristic of chronic hyperplastic candidosis, unlike pseudomembranous candidosis, which can usually be wiped away. UK Faculty of Dental Surgery guidance regards this lesion as potentially malignant and advises specialist management with diagnostic biopsy; histopathology also determines whether epithelial dysplasia is present. Candida culture alone is insufficient because Candida may be present as an oral commensal. Marked pain is more characteristic of erythematous candidosis, and chronic hyperplastic disease is not confined to severely immunocompromised patients. Candida albicans is the species most commonly implicated, not Candida krusei exclusively. Because estimates of malignant transformation are heterogeneous, the defensible clinical statement is that the lesion has potentially malignant significance requiring histopathological assessment, rather than asserting a precise comparative transformation rate.
Reference: Faculty of General Dental Practice (UK) and Faculty of Dental Surgery, Royal College of Surgeons of England. Antimicrobial Prescribing in Dentistry: Good Practice Guidelines, section 15.1.3 Chronic hyperplastic candidosis, 2020. https://www.rcseng.ac.uk/-/media/Files/RCS/FDS/Publications/FDS-AMP-2020.pdf