[Fungi and atopic dermatitis].

Area of Science:

• Mycology
• Dermatology
• Immunology

Background:

• Fungi are increasingly recognized as potential contributors to atopic dermatitis (AD).
• Elevated IgE antibodies to fungi and positive responses to antifungal treatments in some AD cases highlight this connection.
• Specific fungal species, Malassezia and Candida, are frequently implicated in AD exacerbations.

Purpose of the Study:

• To investigate the role of Malassezia and Candida species in atopic dermatitis.
• To evaluate the efficacy of antifungal therapy in managing AD symptoms and fungal colonization.
• To correlate fungal presence and IgE antibody levels with AD severity.

Main Methods:

• Assessing IgE antibody titers against Malassezia and Candida antigens.
• Performing skin prick and patch tests for fungal sensitization.
• Quantifying fungal isolation rates from the skin and nasopharynx of AD patients and controls.
• Monitoring changes in fungal load and IgE levels post-antifungal treatment.

Main Results:

• High anti-Malassezia IgE titers and positive patch tests were observed in AD patients, correlating with disease severity.
• Increased isolation rates of Malassezia were found on the skin of AD patients compared to controls.
• While skin prick tests for Candida were often positive, patch test reactivity was reduced.
• Antifungal therapy demonstrated a 50-65% efficacy rate, significantly decreasing fungal isolation and specific IgE antibody titers.

Conclusions:

• Fungal colonization, particularly by Malassezia, plays a significant role in atopic dermatitis.
• Antifungal therapy can effectively reduce fungal burden and associated IgE responses in AD.
• Antifungal treatment is a viable second-line option for refractory atopic dermatitis cases.