Species isolated as the cause of onychomycosis in patients with pemphigus vulgaris

Abstract

Background: Pemphigus vulgaris (PV) is an autoimmune disease that affects the skin and mucous membranes. It is caused by antibodies directed against desmoglein 3 which leads to the breakdown of the junctions between keratinocytes in the suprabasal epidermis, causing flaccid blisters. Nail involvement in PV has been associated with chronic PV and immunosuppressive therapy, which can increase the risk of bacterial, viral or fungal infection in the nail apparatus. Objectives: To determine which species cause onychomycosis in patients with PV treated with prednisone 1 mg/kg/day. Materials and methods: An observational, descriptive study was performed in 169 patients: 85 were diagnosed with PV and treated with prednisone at a dose of 1 mg/kg/day (patients), and 84 without PV and not treated with steroids (controls). Results: The species most commonly isolated in the PV group was Trichophyton rubrum (29%), followed by Trichophyton mentagrophytes (6%), non-dermatophyte moulds (3%) and Candida albicans (3%). However, in 59% of cases, the causative agent was not identified. Conclusions: The presence of onychomycosis in patients with PV was not associated with the use of glucocorticoids; no greater prevalence of onychomycosis was observed in patients without PV and without steroid therapy.

Keywords

• Tinea
• Candidiasis
• Autoimmune blistering disease
• Onychomycosis in immunosuppressed patients