Plaque
psoriasis is an immune-mediated inflammatory
skin disease associated with the dysregulation of
cytokines, especially those involved in the
interleukin (IL)-23/IL-17 pathways. In recent years, there has been growing interest in developing
biologic therapies that target these pathways. However, inhibition of the
cytokines of the IL-23/IL-17 pathways may increase patients' risk of developing
fungal infections, particularly
oral candidiasis. Therefore, it is important that dermatology practitioners can effectively diagnose and treat
oral candidiasis. In this review, we examine the role of the IL-23/IL-17 pathways in antifungal host defense, and provide a practical guide to the diagnosis and treatment of
oral candidiasis in patients with
psoriasis. Overall, while treatment with anti-IL-17 medications leads to an increased incidence of
oral candidiasis in patients with
psoriasis, these cases are typically mild or moderate in severity and can be managed with standard antifungal
therapy without discontinuing treatment for
psoriasis. If applicable, patients with
psoriasis should also be advised to practice good
oral hygiene and manage or control co-existing diabetes, and should be provided with information on smoking cessation to prevent
oral candidiasis.