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Updated: Oct 13, 2025
Author Spotlight: Oral Candida Diagnosis to Advance Clinical Treatment Regimen for pSS Patients
Published on: March 1, 2024
Prevalence of Candida species in Psoriasis
Kevin Elsner1, Julia Holstein1, Franz Joachim Hilke2
1Department of Dermatology, Eberhard Karls Universität Tübingen, Tübingen, Germany.
Background:
Psoriasis patients are more frequently colonised with Candida species. The correlation between fungal colonisation and clinical severity is unclear, but may exacerbate psoriasis and the impact of antipsoriatic therapies on the prevalence of Candida is unknown.
Objectives:
To examine the prevalence of C species in psoriasis patients compared to an age- and sex-matched control population, we investigated the influence of Candida colonisation on disease severity, immune cell activation and the interplay on psoriatic treatments.
Methods:
The prevalence of C species was examined in 265 psoriasis patients and 200 control subjects by swabs and stool samples for fungal cultures. Peripheral mononuclear blood cells (PBMCs) were collected from 20 fungal colonised and 24 uncolonised patients and stimulated. The expression of interferon (IFN)-γ, IL-17A, IL-22 and tumour necrosis factor (TNF)-α from stimulated PBMCs was measured by quantitative real-time polymerase chain reaction (qPCR).
Results:
A significantly higher prevalence for Candida was detected in psoriatic patients (p ≤ .001) compared to the control subjects; most abundant in stool samples, showing Candida albicans. Older participants (≥51 years) were more frequent colonised, and no correlation with gender, disease severity or systemic treatments like IL-17 inhibitors was found.
Conclusions:
Although Candida colonisation is significantly more common in patients with psoriasis, it does not influence the psoriatic disease or cytokine response. Our study showed that Candida colonisation is particularly more frequent in patients with psoriasis ≥51 years of age. Therefore, especially this group should be screened for symptoms of candidiasis during treatment with IL-17 inhibitors.
Insights
Candida colonization is more common in psoriasis patients, especially those over 51. However, it does not impact disease severity or immune responses, warranting screening during IL-17 inhibitor therapy.
Area of Science:
- Dermatology
- Mycology
- Immunology
Background:
- Psoriasis patients exhibit higher rates of Candida species colonization.
- The link between fungal colonization and psoriasis severity, as well as the impact of treatments, remains unclear.
Purpose of the Study:
- To determine Candida species prevalence in psoriasis patients versus controls.
- To investigate Candida colonization's influence on disease severity, immune cell activation, and psoriatic treatment interactions.
Main Methods:
- Fungal cultures from swabs and stool samples analyzed in 265 psoriasis patients and 200 controls.
- Peripheral mononuclear blood cells (PBMCs) from colonized and uncolonized patients were stimulated.
- Cytokine expression (IFN-γ, IL-17A, IL-22, TNF-α) in PBMCs measured via qPCR.
Main Results:
- Candida prevalence was significantly higher in psoriasis patients (p ≤ .001), predominantly Candida albicans in stool.
- Older individuals (≥51 years) showed increased colonization.
- No correlation found between Candida colonization and gender, disease severity, or IL-17 inhibitor treatments.
Conclusions:
- Candida colonization is more frequent in psoriasis patients but does not affect disease or cytokine response.
- Psoriasis patients aged 51 and older are more prone to Candida colonization.
- Screening for candidiasis is recommended for this age group during IL-17 inhibitor therapy.
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