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    Oral Candida Infection in Psoriatic Patients Treated with IL17A Inhibitors: Report of 3 Cases and a Comprehensive Review of the Literature

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    Author
    Pettas, Efstathios
    Savva, Vasiliki
    Theofilou, Vasileios Ionas
    Georgaki, Maria
    Nikitakis, Nikolaos G.
    Date
    2022-01-01
    Journal
    Diagnostics (Basel, Switzerland)
    Publisher
    MDPI AG
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.3390/diagnostics12010003
    Abstract
    An intact and fully functional immune system plays a crucial role in the prevention of several infectious diseases. Interleukin (IL)17 is significantly involved in oral mucosa immunity against several antigens and microorganisms, including Candida albicans (CA). Herein, we present three cases of oral candidiasis (OC) related to the use of an IL17A inhibitor for psoriasis. Three psoriatic individuals presented for evaluation of widespread symptomatic oral lesions temporally correlated with the onset of IL17A inhibitors (secukinumab in two patients and brodalumab in one patient). Clinical examination revealed either partially removable white plaques in an erythematous background (case #1) or diffuse erythematous lesions (cases #2 and 3) involving several areas of the oral mucosa. Cytology smear, accompanied by histopathologic examination in case #1, confirmed the clinical impression of OC in all three cases. All patients received antifungal therapy with satisfactory clinical response. No discontinuation of the antipsoriatic regimen was recommended, but all patients were advised to remain under monitoring for possible OC relapses. During the last few years, new systemic biologic agents targeting IL17 have been used for the management of variable immunemediated diseases. Few clinical trials and scarce case reports have shown that these medications place individuals at high risk of developing candidiasis. We propose that patients treated with these medications should be at close monitoring for the development of OC and, if it occurs, receive appropriate management. © 2021 by the authors.
    Keyword
    Brodalumab
    Inhibitor
    Interleukin 17
    Oral candidiasis
    Psoriasis
    Secukinumab
    Type 17 immunity
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/17632
    ae974a485f413a2113503eed53cd6c53
    10.3390/diagnostics12010003
    Scopus Count
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