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Author Spotlight: Oral Candida Diagnosis to Advance Clinical Treatment Regimen for pSS Patients
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Nystatin in Psoriasis.

Bhushan Kumar, Inderjeet Kaur, Pushpa Talwar

    Indian Journal of Dermatology, Venereology and Leprology
    |January 28, 2017
    PubMed
    Summary

    This study investigated if gut Candida causes psoriasis. Antifungal treatment with nystatin showed no significant improvement in psoriasis symptoms, suggesting Candida

    Area of Science:

    • Dermatology
    • Mycology
    • Immunology

    Background:

    • Psoriasis is a chronic inflammatory skin condition.
    • The role of gut fungi, specifically Candida, in psoriasis pathogenesis is hypothesized.
    • Understanding potential triggers like Candida is crucial for effective psoriasis management.

    Purpose of the Study:

    • To investigate the hypothesis that gut Candida species provoke psoriasis.
    • To evaluate the efficacy of oral nystatin in reducing Candida colonization and improving psoriasis symptoms.
    • To assess the correlation between Candida presence/clearance and psoriasis lesion severity.

    Main Methods:

    • A cohort of 15 patients with stable psoriasis received oral nystatin for at least 6 weeks.
    • Fungal cultures (throat swab, stool) and candidin intradermal tests were performed before and after treatment.

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  • Psoriasis lesion severity was assessed, with a focus on scaling and clearance.

    • Main Results:

    • Candida species decreased or disappeared in 11 out of 15 patients after nystatin therapy.
    • Only 4 patients reported reduced scaling, and 2 showed over 50% clearance.
    • No significant improvement in psoriasis was observed in 9 patients, and no clear correlation between Candida clearance and lesion improvement was found.
    • Immediate hypersensitivity to candidin was positive in only 3 patients.

    Conclusions:

    • Oral nystatin treatment did not demonstrate a significant therapeutic effect on psoriasis.
    • The hypothesis that gut Candida provokes psoriasis is not supported by this study's findings.
    • Immediate hypersensitivity to Candida antigens does not appear to play a role in psoriasis pathogenesis.