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Factors Associated with Candidiasis in Pemphigus Vulgaris Patients: Results from a Retrospective Study in Two

Andrés Tirado-Sánchez1, Alexandro Bonifaz2, María Guadalupe Frías De León3

  • 1Internal Medicine Department, Hospital General de Zona 30, Instituto Mexicano del Seguro Social, Mexico City 08300, Mexico.

Tropical Medicine and Infectious Disease
|December 22, 2023
PubMed
Abstract

Insights

Candidiasis affects 79% of pemphigus vulgaris patients, linked to corticosteroid dose and inflammation. Other factors like demographics and disease activity also contribute to candidiasis risk in PV.

Area of Science:

  • Autoimmune diseases
  • Infectious diseases
  • Immunology

Background:

  • Pemphigus vulgaris (PV) patients face significant morbidity and mortality from infections, with candidiasis being highly prevalent.
  • Systemic immunosuppressants, particularly high-dose corticosteroids, are suspected contributors to candidiasis in PV.
  • The full spectrum of factors predisposing PV patients to candidiasis remains incompletely understood.

Purpose of the Study:

  • To identify and analyze factors associated with candidiasis development in patients diagnosed with pemphigus vulgaris.
  • To investigate potential links beyond immunosuppressive therapy in the etiology of candidiasis in PV.

Main Methods:

  • A retrospective study involving 100 patients with pemphigus vulgaris.
  • Data were collected from two second-care level hospitals in Mexico between January 2010 and December 2019.
  • The primary outcome measured was the incidence of candidiasis in the selected PV patient cohort.

Main Results:

  • Candidiasis was diagnosed in 79% (79 out of 100) of the pemphigus vulgaris patients studied.
  • A maximum daily corticosteroid dose of 55 mg in the preceding year was significantly associated with candidiasis (p=0.001).
  • An elevated neutrophil-to-lymphocyte ratio also demonstrated a significant association with candidiasis in PV patients (p=0.001).

Conclusions:

  • Candidiasis risk in pemphigus vulgaris extends beyond corticosteroid use.
  • Demographic factors, pemphigus vulgaris disease activity, and systemic inflammation linked to autoimmunity are identified as contributing risk factors.
  • A comprehensive understanding of these multifactorial risks is crucial for managing candidiasis in PV patients.
Keywords:
candidemiacandidiasiscorticosteroidsneutrophil/lymphocyte ratiopemphigus vulgarisplatelet/neutrophil ratio

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