Open AccessA Case of Widespread Dermatophytosis during Interleukin-17A Inhibitor Treatment in Psoriasis Patient with Tinea Unguium
Author(s) -
Jeongsoo Lee,
Nuri Na,
Joon Soo Park
Publication year - 2019
Publication title -
korean journal of medical mycology/daehan'yi jin'gyun haghoeji
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.101
H-Index - 9
eISSN - 2465-8278
pISSN - 1226-4709
DOI - 10.17966/jmi.2019.24.4.100
Subject(s) - psoriasis , medicine , dermatology , terbinafine , proinflammatory cytokine , generalized pustular psoriasis , immunology , erythema , candida albicans , interleukin 17 , inflammation , antifungal , microbiology and biotechnology , biology , itraconazole
Interleukin-17 (IL-17) is secreted by a class of helper T cells called Th17 cells, which stimulates keratinocytes to secrete proinflammatory mediator and to recruit other inflammatory cells in psoriatic skins. IL-17A inhibitor was approved for the management of psoriatic arthritis by FDA. It is the one of the biologics approved as first-line therapy for the management of psoriasis. But several studies show some side effects of IL-17A inhibitor such as upper respiratory infection and fungal infection like Candida albicans. Herein we report a widespread dermatophytosis during IL-17A inhibitor treatment. A 66-year-old male patient, with tinea unguium and chronic plaque psoriasis for several decades, presented with multiple erythematous scaly macules and patches for 2 weeks. He medicated IL-17A inhibitor for treating psoriasis total 3 times and last injection was 1 week ago. Dermatological examination revealed the involvement of 20% body surface area in the form of erythematous scaly macules and patches. KOH mount revealed the presence of numerous hyphae. The patient was started on oral terbinafine, topical isoconazole and efinaconazole. His skin lesions were improved after 1 month of anti-fungal therapy. IL-17 plays an important role in mucocutaneous microbial defense. So, fungal infection should be checked in using IL-17A inhibitor patients periodically.