Sensitization and cross-reactions of dermatophyte and Candida albicans allergens in patients with chronic urticaria

• Published in: International journal of dermatology Vol. 55; no. 10; pp. 1138 - 1142
• Main Authors: Zhang, Min, Liu, Fang, Liu, Haibo, Shen, Yongnian, Kong, Qingtao, Sang, Hong
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.10.2016
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antigens, Fungal - immunology; Candida albicans; Candida albicans - immunology; Child; Chronic Disease; Cross Reactions; Epidermophyton - immunology; Epidermophyton floccosum; Female; Humans; Hypersensitivity - immunology; Hypersensitivity - microbiology; Male; Middle Aged; Onychomycosis - complications; Onychomycosis - immunology; Skin Tests; Trichophyton; Trichophyton - immunology; Trichophyton mentagrophytes; Trichophyton rubrum; Urticaria - complications; Urticaria - immunology; Young Adult
• ISSN: 0011-9059; 1365-4632; 1365-4632
• DOI: 10.1111/ijd.13162

Background Chronic fungal infections are known to exacerbate allergic symptoms, including those of asthma and chronic urticaria (CU). We applied four prepared fungal antigens of Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, and Candida albicans to examine sensitization to each in subjects with CU and onychomycosis and in healthy subjects, and to evaluate the etiologic role of dermatophytic infection in CU and observe any cross‐reactions among these four antigens. Methods Participants were divided into four groups, including those with CU with onychomycosis (experiment group), those with onychomycosis without allergic diseases (control group 1), those with CU without fungal infections (control group 2), and a healthy group (control group 3). In all subjects, skin prick tests with the four fungal antigens were performed. Subjects in the experiment group and control group 1 were also submitted to mycologic investigations. Results The experiment group showed significantly higher rates of positivity than the three control groups to T. rubrum, E. floccosum, and T. mentagrophytes antigens. Control group 1 showed rates higher than those in control groups 2 and 3; no significant difference emerged between control groups 2 and 3. Positivity to the C. albicans antigen did not differ among the four groups. In control group 1, rates of positivity to the three dermatophytic antigens did not differ significantly but did for C. albicans. Conclusions Fungal infection seems to be an important determinant of trichophyton hypersensitivity. Cross‐reactions among T. mentagrophytes, T. rubrum, and E. floccosum antigens were obvious, but none emerged between the antigens of the three dermatophytes and that of C. albicans.