Study of Fungal Growth in Plaque Psoriasis Patients

Abstract

Background: Psoriasis is a common, chronic, immune-mediated disease manifested mainly as skin lesions and extracutaneous comorbidities associated with systemic inflammation. Typical skin manifestations of psoriasis include erythematous, indurated, and scaling plaques that are painful, itchy, and have a burning sensation. Fungi as Malassezia and Candida albicans have been implicated in the pathogenesis of psoriasis. Aim of work: is to study the association between the presence of different fungal growth and psoriasis. Patients and Methods: This study was carried out on a total of 30 patients clinically diagnosed to have psoriasis, attending the outpatient clinic of the Dermatology and Andrology Department of Benha University Hospital, from April 2019 to July 2020. All patients were subjected to complete history taking, general examination, and dermatologic examination to confirm the diagnosis. An informed consent approved by the Research Ethics Committee at Faculty of Medicine Benha University was taken from all individuals before being enrolled in this study. From the lesions, scales were collected by gentle scraping, examined microscopically for detection of any fungal growth using 10% potassium hydroxide (KOH) and then cultured on Sabouraud's Dextrose Agar (SDA) with and without cyclohexamide and Dixon's medium for identification of any fungal growth. Results: The mean age of patients was 38.3, twenty patients were males and 15 patients reported to be smokers. Only seven patients had positive family history. Most patients had gradual onset and course of exacerbation and remission. Twenty two cases of psoriasis showed positive KOH and culture for fungal growth. 10 cases were positive for Aspergillus, 7 for Candida, 4 for Malassezia, and only one case for Dermatophytes. Conclusion: Fungal infection may play a role in the pathogenesis of psoriasis, its prevalence is still a matter of debate and its exact role is in need for more research to be revealed.