Abstract
Viable and heat-killed yeast form cells of Candida albicans (108/ml, 0.1ml) were respectively inoculated in the skin of guinea pig flank. Follow-up and histopathological study of the skin biopsies showed the following. 1) Neutrophil chemotaxis was observed at the inoculation sites both of viable and heat-killed cell, but was more remarkable at the former. 2) Germ tube formation of viable cells occurred within a few hours after inoculation. Quantitatively, the germination was inversely related to the neutrophil infiltration. Degenerated and/or phagocytized fungal elements were seen in the nest of inflammatory cells. 3) A large number of viable cells in the dermis was characteristically surrounded by a two-layered wall of inflammatory cells. Thereafter, actively proliferating epithelium engulfed and continuously excluded them from the dermis to the exterior. This mechanism is explained as the phenomenon of transepithelial elimination. A few organisms were seen in the cytoplasm of histiocytes and giant cells outside the abscess. 4) Heat-killed cells were phagocytized and digested in the cytoplasm of histiocytes and giant cells without epithelial response.
These suggested that the development of deep dermal candidiasis may be inhibited by a defense system consisting of the inflammatory cell infiltration and proliferating epithelium in response to viable C. albicans. Furthermore, anastomosing follicular epithelium deserves a special emphasis of the transepithelial elimination.
