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Objectives The epidemiologic distribution of  non-albicans  species in the oral cavity of oral lichen planus (OLP) patients remains uncertain. Therefore, the aim of this study was to identify factors associated with the presence of  C. dubliniensis  and other  non-albicans  species. Furthermore, independent risk factors for  Candida  superinfection in OLP should be identified. Material and methods Epidemiologic data and microbiological findings from 268 symptomatic OLP patients who underwent continuous oral swab culture over a 5-year period (2015–2019) were retrospectively reviewed.  Candida  species identification and semi-quantification were obtained by culture on CHROMagar Candida, followed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Results C. albicans  was the most frequently isolated species (72.3%), followed by  C. glabrata  (7.3%),  C. dubliniensis  (5.8%),  C. krusei  and  C. parapsilosis  (both 2.6%). The presence of  C. dubliniensis  was significantly associated with tobacco smoking. Other  non-albicans  spp. were significantly more often detected in patients using removable dentures. Increasing age and the intake of psychotropic drugs were identified as independent risk factors of  Candida  superinfection in OLP. Conclusion In OLP patients, certain local and systemic factors increase the risk of carrying potentially drug-resistant  Candida  species and the development of  Candida  superinfection of OLP lesions. Clinical relevance Due to the frequent detection of  non-albicans  species in OLP, resistance or at least reduced sensitivity to azole antifungals should be expected, especially in smokers and patients using removable dentures. In the case of oral complaints, a superinfection with  Candida  should be considered, whereby older patients and patients taking psychotropic drugs have an increased risk for oral infection with  Candida .

clinical oral investigations

Factors influencing the presence of Candida dubliniensis and other non-albicans species in patients with oral lichen planus: a retrospective observational study