Properties of Candida Albicans: Mycogenic Sensitization as a Trigger of Atopic Dermatitis and Psoriasis Vulgaris

Background : Candida spp. are common opportunistic microorganisms in the human body. The most prevalent and highly pathogenic species in the mycobiome is Candida albicans, which induces mycogenic sensitization Objective: This study aimed to determine mycogenic sensitization to Candida albicans in patients with atopic dermatitis (AD) and psoriasis vulgaris (PV) living in Uzbekistan. Materials and methods: We enrolled 75 patients with AD aged 18 to 67 years and 69 patients with PV aged 23 to 72 years. Mycological examination of intestinal samples (culture on Sabouraud medium) was performed in all patients. Total IgE levels were measured using CLIA, and IgG Candida albicans was determined by ELISA. In AD patients, the POEM index was assessed, while in PV patients the PASI score was evaluated as well. Results: Intestinal proliferation of Candida spp. exceeding 10³ CFU/ml was detected in 61% AD patients (58/75) and 45% PV patients (31/69). Species identification revealed a predominance of Candida albicans in 85% of AD cases and 77% of PV cases. In the control group, Candida spp. were detected in 36.6% (11/30); all isolates were identified as Candida albicans . In AD patients with intestinal candidiasis caused by Candida albicans , the total IgE level was 232.8 ± 13.9 IU/mL, in AD patients without intestinal candidiasis – 136 ± 9 IU/mL, and in the control group – 90 ±5.5 IU/mL (p<0.001). The mean IgG Candida albicans in AD patients with intestinal candidiasis was 0.706 ± 0.16 ng/mL, in AD patients without intestinal candidiasis – 0.428±0.07 ng/mL, healthy individuals 0.303 ± 0.09 (p<0.001). In PV patients with intestinal candidiasis caused by Candida albicans , the total IgE level was 131 ± 9.3 IU/mL, in PV patients without intestinal candidiasis – 121.4 ± 13.2 IU/mL, and in the control group – 90 ± 5.5 IU/mL (p<0.001). The mean IgG Candida albicans in PV patients with intestinal candidiasis was higher than in the control group (0.562 ± 0.3 ng/mL vs 0.303 ± 0.09; p<0.001) and PV patients without intestinal candidiasis (0.438 ± 0.18 ng/mL; p>0.05). In AD patients complicated by mycogenic sensitization, the POEM was 21.5 ± 2.3 points, whereas in AD patients without mycogenic sensitization, the index was 12.2 ± 2.8 points. In PV patients complicated by mycogenic sensitization, the PASI was 20.7 ± 2.46 points, while in those without mycogenic sensitization, the PASI was 11.4 ± 2.26 points. Conclusion: Mycogenic sensitization was detected in 61% AD cases and 45% PV cases, accompanied by intestinal candidiasis and elevated levels of total IgE and IgG Candida albicans . The skin manifestations of AD and PV complicated by mycogenic sensitization were characterized as severe, according to the POEM and PASI indices.