Related Experiment Videos
Microorganisms in intertriginous psoriasis: no evidence of Candida
Ingela Flytström1, Ing-Marie Bergbrant, Johanna Bråred
1Department of Dermatology and Venereology, Sahlgrenska University Hospital, Göteborg, Sweden. ingela.flytstrom@vgregion.se
Abstract:
Infection can be a trigger and an aggravating factor in psoriasis. Antibacterial and/or antifungal agents are commonly used in the treatment of intertriginous psoriasis, because it is believed that flexures in psoriasis are often colonized by Candida species and Staphylococcus aureus. Bacterial and fungal cultures were studied from 32 psoriatic patients with no topical treatment in the intertriginous areas, from 13 psoriatic patients treated with topical steroids and from 19 patients with no psoriasis or other affections of the skinfolds. Untreated psoriatic patients were colonized by S. aureus significantly more often than the control group but infection seemed to be unlikely. Candida was not found in any of the groups. It is proposed that intertriginous psoriasis be treated with topical steroids alone and that the routine use of antimycotic and antibacterial combinations should be avoided.
Insights
Infection can worsen psoriasis. This study found Staphylococcus aureus colonization in untreated psoriasis patients, but not Candida. Topical steroids alone are recommended for intertriginous psoriasis, avoiding routine antibacterial and antifungal treatments.
Area of Science:
- Dermatology
- Microbiology
- Infectious Diseases
Background:
- Infection is a known trigger and aggravator for psoriasis.
- Intertriginous psoriasis is often treated with antibacterial and antifungal agents due to suspected colonization by Staphylococcus aureus and Candida species.
Purpose of the Study:
- To investigate the presence of bacterial and fungal colonization in the intertriginous areas of psoriasis patients.
- To evaluate the necessity of routine antibacterial and antifungal treatments for intertriginous psoriasis.
Main Methods:
- Bacterial and fungal cultures were performed on samples from three groups: untreated psoriatic patients, psoriatic patients on topical steroids, and a control group without psoriasis.
- Patient groups were compared for colonization rates of Staphylococcus aureus and Candida species.
Main Results:
- Untreated psoriatic patients showed significantly higher colonization rates of Staphylococcus aureus compared to the control group.
- Candida species were not detected in any of the study groups.
- Despite increased S. aureus colonization, overt infection was deemed unlikely in the untreated psoriatic group.
Conclusions:
- Routine use of combined antibacterial and antifungal agents for intertriginous psoriasis is not supported by these findings.
- Topical corticosteroids alone are proposed as a sufficient treatment for intertriginous psoriasis.
- Further research may be warranted to fully understand the role of S. aureus in intertriginous psoriasis.