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Candida albicans and the Normal Skin

Philip J. Kozinn, MD; Claire L. Taschdjian, MS
JAMA. 1966;195(6):499. doi:10.1001/jama.1966.03100060139049.
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To the Editor:—  Two recent articles by F.A.J. Kingery, MD, scored the general diagnostic ineptitude in recognizing possible cutaneous fungal infections. The author presented worthwhile clinical pictures and corrected important pitfalls in diagnosis. However, as he expanded his thesis, he made remarks that are as seriously in error as those he tried to correct.In "Don't Forget about Candidiasis" (191:851, 1965), the statement is made: "Since C albicans has commonly been recovered from skin and mucous surfaces in the absence of disease, the clinician must be familiar with the pathological patterns which may result from the presence of this organism. Identification of pseudohyphae in potassium hydroxide mount and culture on Sabouraud's agar provide positive identification."Though frequently present on normal mucous surfaces, C albicans is not commonly found on normal skin.1,2 This faulty concept is being thoughtlessly propagated in the literature, despite ample recorded evidence to the contrary.

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