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Background: The present study aimed to analyze the histopathologic aspects of cases diagnosed as chronic hyperplastic candidiasis (CHC) in an oral pathology service, pointing out the most important features found. Methods: All cases histopathologically diagnosed as CHC between 2002 and 2018 were retrieved from the files of the service. Data of the patients and the lesions were collected. Histopathological analysis was performed to evaluate the microscopic characteristics and the amount of Candida present. Results: Thirty-six cases of CHC were retrieved. Women were more affected and there was a predilection for Whites. Most lesions appeared as a nodule or a white plaque, asymptomatic, on the tongue or buccal mucosa. Histopathologically, statistical significance was noted for the presence of epithelial hyperplasia, exocytosis, and mononuclear inflammatory infiltrate. Interestingly, only the association between dysplasia and the amount of fungus was noted. Conclusions: CHC appears to be a distinct entity presenting typical histopathologic aspects. CHC might even show epithelial dysplasia. In those cases, the presence of a large amount of Candida together with other histopathological features should lead to the diagnosis of CHC and subsequent treatment. However, close follow up is important. K E Y W O R D S chronic hyperplastic candidiasis, diagnosis, histopathology, leukoplakia, oral pathology 1 | INTRODUCTION Chronic hyperplastic candidiasis (CHC) is recognized as the least common type of oral candidiasis, as the pseudomembranous and erythematous forms are far more frequent. Despite being recognized as a specific entity, it sometimes represents a dilemma to clinicians and oral pathologists especially regarding the possibility of malignant transformation. 1-3 Its main differential diagnosis would be oral dysplastic leukoplakias associated with a Candida infection. In other words, how to know whether fungus is the cause of the lesion or only present because of its opportunistic behavior? Currently, if the lesion is not totally removed in the first biopsy, histopathologic aspects will be determinant for the diagnosis of CHC and point to further treatment. 1-3 The fact that leukoplakias might be associated with Candida was first reported by Cernea et al. 4 and by Jepsen and Winther. 5 Cawson 6 was the first to consider the lesion as a specific pathological entity. Studies have shown that CHC is an adult disease, with the mean age being 50 years, but affecting a wide age range (31-81 yo). Despite candidiasis being more frequent in women, CHC has been more described in men. 7-9 It usually appears without association with

CSC markers are expressed in potentially malignant and malignant lesions of the lip. Their expressions were invariable between AC and LSCC and unrelated to p53. p75NTR expression increased with the worsening of epithelial dysplasia grade.

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