Faeces samples taken from 343 patients with psoriasis and 581 patients with atopic dermatitis were subjected to mycological examination. Yeasts were detected in 68% of the psoriatics and in 70% of the patients with atopic dermatitis but in only 54% of the controls (n = 50). Qualitative analysis revealed a predominance of Candida albicans. Non-pathogenic yeasts constituted only 1% in each of these groups. Of the hyphomycetes, Geotrichum candidum occurred in 22% of the psoriatics, in 10% of the atopic dermatitis patients and in 3% of the controls. Aspergillus species were found in 1% of the patients but not in the controls. Stool samples collected on three consecutive days from 141 patients were examined for yeasts. Qualitative correlation between all three samples was shown in 95% of the patients and quantitative correlation in 38%. Deviations were mainly of exponential magnitude. Germ cell concentration of 10(4) cells per ml and above were measured in 38% of the psoriatics and in 28% of the atopic dermatitis patients but in only 22% of the test subjects with healthy skin. There was no correlation between the concentration levels of yeasts in the faeces and the extent of psoriasis or atopic dermatitis.
Zusammenfassung: Phospholipase‐Aktivität von Candida albicans‐Stämmen wurde mit einer Agarplatten‐Methode unter Zusatz von Eigelb bestimmt. 11 Stämme aus Stuhlproben von Psoriatikern wurden mit 35 C. albicans‐Stämmen aus Stuhlproben von Patienten mit der Verdachts‐Diagnose auf intestinalen Soorbefall verglichen. Die Enzymaktivitäten aller Stämme wurden mit derjenigen eines hoch pathogenen C. albicans Stammes verglichen, der in einem Septikämiemodell an Albinomäusen verwendet wird. Die Stämme aus den Psoriatikern wiesen 81 ± 30% der Enzymaktivität des Referenzstammes auf, wogegen die Stämme aus dem Kontrollkollektiv nur 46 ± 28% der Enzymaktivität des Referenzstammes zeigten. Die Unterschiede sind signifikant (Irrtumswahrscheinlichkeit < 0,001). Es bleibt zu klären, ob diese Enzym‐Freisetzung einer Hefe im Darm den Ausbruch von psoriatischen Hautveränderungen bewirkt.
Summary: Phospholipase activity of Candida albicans strains was measured by means of an agar plate method containing egg yolk. 11 strains, isolated out of feces samples from patients suffering from psoriasis were compared with 35 strains of C. albicans, isolated from patients with suspected diagnosis of intestinal candidosis. The enzymatic activity of all strains was compared with the activity of a highly pathogenic strain of C. albicans from an intravenous animal infection model. The psoriasis derived strains exhibited 81 ± 30% activity of the reference strain, whereas the strains derived from intenstinal candidosis exhibited only 46 ± 28% enzymatic activity of the reference strain. The mean values are significantly different (p < 0,001). It remains to be investigated whether this enzyme activity of yeast cells in the gut triggers the eruption of psoriasis on the skin.
Human skin can be colonized by different yeasts that may have an impact on skin pigmentation. In order to study this effect normal human melanocytes were cultured with different yeasts. Reverse transcription polymerase chain reaction (RT-PCR) analysis gives evidence that Candida albicans suppresses the transcription of melanogenesis enzymes.
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