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Fungal Infections among Psoriatic Patients: Etiologic Agents, Comorbidities, and Vulnerable Population

Mostafa Chadeganipour1, Shahla Shadzi1, Rasoul Mohammadi1,2

  • 1Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Autoimmune Diseases
|September 27, 2021
PubMed
Abstract

Insights

Fungal infections, particularly dermatophytes, are implicated in psoriasis development. Identifying these fungi in psoriatic patients may guide combined anti-inflammatory and antifungal treatments for better lesion management.

Area of Science:

  • Dermatology
  • Mycology
  • Immunology

Background:

  • Psoriasis affects 2-3% of the population, characterized by chronic skin and joint inflammation.
  • Microflora imbalance and fungal superantigens are hypothesized to trigger or exacerbate psoriasis.
  • This study aimed to identify fungal species associated with psoriasis.

Purpose of the Study:

  • To identify fungal species present in patients diagnosed with psoriasis.
  • To investigate the potential role of fungi in the pathogenesis of psoriasis.
  • To inform potential therapeutic strategies for psoriasis management.

Main Methods:

  • Phenotypic identification of clinical fungal isolates using microscopy, culture, urea hydrolysis, hair perforation, and rice grain tests.
  • Molecular identification of Candida and Malassezia species via PCR-RFLP and PCR-sequencing.
  • Inclusion of 289 psoriasis patients from March 2016 to May 2019.

Main Results:

  • Fungal infections were detected in 15.9% (46/289) of psoriatic patients.
  • Dermatophytes were the most common cause (54.3%), followed by Candida spp. (19.5%) and Malassezia spp. (15.2%).
  • The most prevalent species identified were Malassezia restricta (10.8%) and Candida glabrata (8.7%).

Conclusions:

  • Fungal pathogens, especially dermatophytes, likely contribute to psoriasis development.
  • High yeast colonization rates suggest combined anti-inflammatory and antifungal therapies could improve chronic lesion management.
  • Routine mycological testing is recommended for psoriatic patients to detect fungal infections.

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