Onychomycosis in Psoriatic Patients with Nail Disorders: Aetiological Agents and Immunosuppressive Therapy

Psoriasis and psoriatic arthritis are chronic, relapsing, immune-based diseases. Psoriatic patients may have nail involvement in 50 to 80% of cases, and this may reach 85% in patients with joint disease, in spite of the fact that the relationship between psoriasis and onychomycosis is not well estab...

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Main Authors: Núbia Carvalho Pena de Oliveira Praeiro Alves, Tomaz de Aquino Moreira, Lucivânia Duarte Silva Malvino, José Joaquim Rodrigues, Roberto Ranza, Lúcio Borges de Araújo, Reginaldo dos Santos Pedroso
Format: Article
Language:English
Published: Hindawi Limited 2020-01-01
Series:Dermatology Research and Practice
Online Access:http://dx.doi.org/10.1155/2020/7209518
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spelling doaj-b25ff5f5b3944fcc8dcfea88f61e84832020-11-25T02:12:10ZengHindawi LimitedDermatology Research and Practice1687-61051687-61132020-01-01202010.1155/2020/72095187209518Onychomycosis in Psoriatic Patients with Nail Disorders: Aetiological Agents and Immunosuppressive TherapyNúbia Carvalho Pena de Oliveira Praeiro Alves0Tomaz de Aquino Moreira1Lucivânia Duarte Silva Malvino2José Joaquim Rodrigues3Roberto Ranza4Lúcio Borges de Araújo5Reginaldo dos Santos Pedroso6Postgraduate Program in Health Sciences, School of Medicine, Federal University of Uberlândia, Pará Av. 1720, Umuarama, Uberlândia, Minas Gerais, BrazilClinical Analysis Laboratory of the Clinical Hospital of Uberlândia, Federal University of Uberlândia, Pará Av. 1720, Umuarama, Uberlândia, Minas Gerais, BrazilClinical Analysis Laboratory of the Clinical Hospital of Uberlândia, Federal University of Uberlândia, Pará Av. 1720, Umuarama, Uberlândia, Minas Gerais, BrazilRheumatology Service of the Clinical Hospital of Uberlândia, Federal University of Uberlândia, Pará Av. 1720, Umuarama, Uberlândia, Minas Gerais, BrazilRheumatology Service of the Clinical Hospital of Uberlândia, Federal University of Uberlândia, Pará Av. 1720, Umuarama, Uberlândia, Minas Gerais, BrazilFederal University of Uberlândia, João Naves de Ávila Av. 120, 1F Block, Santa Monica, Uberlândia, Minas Gerais, BrazilPostgraduate Program in Health Sciences, School of Medicine, Federal University of Uberlândia, Pará Av. 1720, Umuarama, Uberlândia, Minas Gerais, BrazilPsoriasis and psoriatic arthritis are chronic, relapsing, immune-based diseases. Psoriatic patients may have nail involvement in 50 to 80% of cases, and this may reach 85% in patients with joint disease, in spite of the fact that the relationship between psoriasis and onychomycosis is not well established. The aim of this study was to investigate the occurrence of onychomycosis in patients with nail disorders and diagnosis of psoriasis and psoriatic arthritis. This was a cross-sectional study in which 38 patients diagnosed with psoriasis and/or psoriatic arthritis were interviewed and had altered nail samples analysed by mycological and histopathological exams. Twenty-two (57.89%) patients had a confirmed diagnosis for onychomycosis. Seventeen (44.8%) had a positive direct mycological examination, 16 (42.1%) had positive cultures, and 12 (31.6%) were positive for fungi by histopathological examination. Dermatophytes were identified in nine (56.3%) cultures, and of these, eight were Trichophyton rubrum and one T. tonsurans. Yeasts were isolated in seven patients (43.75%), which included four Candida parapsilosis and three C. albicans. Six patients (15.78%) were not using immunosuppressive therapy, and the others were using methotrexate, etanercept, adalimumab, infliximab, secukinumab, or golimumab, in monotherapy or in combination with other drugs. The confirmed onychomycosis rate in patients using methotrexate alone was 92.8% (n = 13). We concluded that it is possible that there is a positive relationship between psoriatic disease and onychomycosis. And we highlight that it is also worth investigating in the future the possible role of immunosuppressive therapy (mainly methotrexate) as a predisposing factor for the development of fungal infections in psoriatic patients.http://dx.doi.org/10.1155/2020/7209518
collection DOAJ
language English
format Article
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author Núbia Carvalho Pena de Oliveira Praeiro Alves
Tomaz de Aquino Moreira
Lucivânia Duarte Silva Malvino
José Joaquim Rodrigues
Roberto Ranza
Lúcio Borges de Araújo
Reginaldo dos Santos Pedroso
spellingShingle Núbia Carvalho Pena de Oliveira Praeiro Alves
Tomaz de Aquino Moreira
Lucivânia Duarte Silva Malvino
José Joaquim Rodrigues
Roberto Ranza
Lúcio Borges de Araújo
Reginaldo dos Santos Pedroso
Onychomycosis in Psoriatic Patients with Nail Disorders: Aetiological Agents and Immunosuppressive Therapy
Dermatology Research and Practice
author_facet Núbia Carvalho Pena de Oliveira Praeiro Alves
Tomaz de Aquino Moreira
Lucivânia Duarte Silva Malvino
José Joaquim Rodrigues
Roberto Ranza
Lúcio Borges de Araújo
Reginaldo dos Santos Pedroso
author_sort Núbia Carvalho Pena de Oliveira Praeiro Alves
title Onychomycosis in Psoriatic Patients with Nail Disorders: Aetiological Agents and Immunosuppressive Therapy
title_short Onychomycosis in Psoriatic Patients with Nail Disorders: Aetiological Agents and Immunosuppressive Therapy
title_full Onychomycosis in Psoriatic Patients with Nail Disorders: Aetiological Agents and Immunosuppressive Therapy
title_fullStr Onychomycosis in Psoriatic Patients with Nail Disorders: Aetiological Agents and Immunosuppressive Therapy
title_full_unstemmed Onychomycosis in Psoriatic Patients with Nail Disorders: Aetiological Agents and Immunosuppressive Therapy
title_sort onychomycosis in psoriatic patients with nail disorders: aetiological agents and immunosuppressive therapy
publisher Hindawi Limited
series Dermatology Research and Practice
issn 1687-6105
1687-6113
publishDate 2020-01-01
description Psoriasis and psoriatic arthritis are chronic, relapsing, immune-based diseases. Psoriatic patients may have nail involvement in 50 to 80% of cases, and this may reach 85% in patients with joint disease, in spite of the fact that the relationship between psoriasis and onychomycosis is not well established. The aim of this study was to investigate the occurrence of onychomycosis in patients with nail disorders and diagnosis of psoriasis and psoriatic arthritis. This was a cross-sectional study in which 38 patients diagnosed with psoriasis and/or psoriatic arthritis were interviewed and had altered nail samples analysed by mycological and histopathological exams. Twenty-two (57.89%) patients had a confirmed diagnosis for onychomycosis. Seventeen (44.8%) had a positive direct mycological examination, 16 (42.1%) had positive cultures, and 12 (31.6%) were positive for fungi by histopathological examination. Dermatophytes were identified in nine (56.3%) cultures, and of these, eight were Trichophyton rubrum and one T. tonsurans. Yeasts were isolated in seven patients (43.75%), which included four Candida parapsilosis and three C. albicans. Six patients (15.78%) were not using immunosuppressive therapy, and the others were using methotrexate, etanercept, adalimumab, infliximab, secukinumab, or golimumab, in monotherapy or in combination with other drugs. The confirmed onychomycosis rate in patients using methotrexate alone was 92.8% (n = 13). We concluded that it is possible that there is a positive relationship between psoriatic disease and onychomycosis. And we highlight that it is also worth investigating in the future the possible role of immunosuppressive therapy (mainly methotrexate) as a predisposing factor for the development of fungal infections in psoriatic patients.
url http://dx.doi.org/10.1155/2020/7209518
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