Psoriasis and psoriatic arthritis are chronic, relapsing, immune-based diseases. Psoriatic patients may have nail involvement in 50\nto 80% of cases, and this may reach 85% in patients with joint disease, in spite of the fact that the relationship between psoriasis and\nonychomycosis is not well established. The aim of this study was to investigate the occurrence of onychomycosis in patients with\nnail disorders and diagnosis of psoriasis and psoriatic arthritis. This was a cross-sectional study in which 38 patients diagnosed\nwith psoriasis and/or psoriatic arthritis were interviewed and had altered nail samples analysed by mycological and histopathological\nexams. Twenty-two (57.89%) patients had a confirmed diagnosis for onychomycosis. Seventeen (44.8%) had a\npositive direct mycological examination, 16 (42.1%) had positive cultures, and 12 (31.6%) were positive for fungi by histopathological\nexamination. Dermatophytes were identified in nine (56.3%) cultures, and of these, eight were Trichophyton rubrum\nand one T. tonsurans. Yeasts were isolated in seven patients (43.75%), which included four Candida parapsilosis and three C.\nalbicans. Six patients (15.78%) were not using immunosuppressive therapy, and the others were using methotrexate, etanercept,\nadalimumab, infliximab, secukinumab, or golimumab, in monotherapy or in combination with other drugs. The confirmed\nonychomycosis rate in patients using methotrexate alone was 92.8% (n = 13). We concluded that it is possible that there is a\npositive relationship between psoriatic disease and onychomycosis. And we highlight that it is also worth investigating in the\nfuture the possible role of immunosuppressive therapy (mainly methotrexate) as a predisposing factor for the development of\nfungal infections in psoriatic patients.
Loading....