143: Inverse Psoriasis + Candida Connection

Though it’s a less common form of psoriasis, Inverse Psoriasis (IP) impacts about 30% of those living with Plaque Psoriasis.

One thing about having Inverse Psoriasis that really caught my attention was the connection to getting fungal infections at the site of IP rashes!

I always ask clients regardless of what their main concern is if they have had issues with fungus or yeast in other areas of the body.

And it’s not uncommon for me to find that fungal issues elsewhere tend to match up to having fungal overgrowth in the gut.

I wanted to share my alternative perspective on Inverse Psoriasis so that if you’re struggling with it (or you know someone who is), you can use it as a clue!

You don’t have to feel embarrassed or live in shame about it because knowing that IP is present could help you identify other issues driving your psoriasis under the surface.

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In this episode:

  • What is inverse psoriasis?
  • Candida + other bacteria that make IP worse
  • Conventional ways IP is addressed
  • Shocking candida stat that all Psoriasis warriors should know
  • Alterative thoughts on IP + where to dig deeper

Quotes:

One study found that 56.6% of Inverse Psoriasis rashes had Corynebacterium minutissimum present making symptoms worse.

A 2018 paper found that the “prevalence of Candida spp. colonization was significantly higher in patients with psoriasis compared with the control group.”

Bacteria

Inverse Psoriasis + Candida Connection (FULL TRANSCRIPT)

Welcome back to episode #143 of the Healthy Skin Show!

In today’s episode, I want to talk about the relationship between a specific type of psoriasis called Inverse psoriasis and candida overgrowth.

Fungal issues are often mentioned in passing such as “since these areas are more yeast-prone, sometimes fungal overgrowth can occur”.

And it doesn’t stop there…

The connections between Inverse Psoriasis and microbiome dysbiosis go deeper than just being a fungal issue as there are bacteria that can play a role too!

So if you’re anything like me, the repeated mentions about these rashes being in fungal-prone areas should get you thinking.

A whole-body root cause approach makes you wonder if there could be a potential connection between the microorganisms living there and deeper dysbiosis issues.

My mind always looks for potential hidden root causes — because you and I both know that your skin issues are way more than JUST skin issues.

Digging comprehensively into client cases has shown me the value in considering these details as clues that can illuminate where to dig!

All with the intention to help you get actionable answers with the hope of finally rebuilding healthier skin.

Also, if you’re at the beginning of your journey with psoriasis, check out THIS episode!

Woman thinking about Inverse Psoriasis

What Is Inverse Psoriasis?

Inverse psoriasis (also called Intertriginous psoriasis) is a form of psoriasis that can show up in the folds of the body — under breasts, between deep folds of skin, in the armpits and in the groin area. It can appear along with other types of psoriasis.(1)

It also affects people of all different ages — from babies to adults.(2)

A small segment of psoriatic warriors has inverse psoriasis (IP) — about 3 to 7%.(3)

In this group, the skin of the genitals will be involved in about 80% of the cases.(4) This facet of IP can make it embarrassing to seek help from a doctor.

Interesting fact — approximately 30% of those living with plaque psoriasis also have inverse psoriasis.(4)

IP rashes look much different from the scaly plaques that most people associate with psoriasis. Instead, inverse psoriasis rashes are shiny and smooth.

Because these areas tend to be damper, you have to be on the lookout for fungal (and even bacterial) overgrowth as well.

Typical conventional therapies for inverse psoriasis include calcipotriene (which I’ve talked about in Episode #99 of the Healthy Skin Show), coal tar, UVB light therapy, Elidel, Protopic, Embrel, Remicade, methotrexate, and topical steroids (sometimes containing anti-fungal meds as well).(1,3)

Microscope

Inverse Psoriasis + Skin Dysbiosis

That all said, literature exists which highlights the connects to both fungal and even bacterial overgrowths that can happen at the site of these inverse psoriasis rashes.

Some of the organisms mentioned include Candida species, Corynebacterium minutissimum, “Staphylococcus aureus, Streptococcus, Pseudomonas aeruginosa, Proteus mirabilis and Proteus vulgaris.”(5,6)

First of all, one paper I reviewed found that Corynebacterium minutissimum was present in 56.6% of those with inverse psoriasis.(6) It’s worth noting because this bacteria could be a culprit causing your inverse psoriasis to flare and become very uncomfortable.

Secondly, that list of organisms I just mentioned is a pretty interesting list of bugs. Especially if we were talking about your gut as they could certainly be cause for concern!

While this conversation right now is focused upon the skin microbiome, you know from listening to the Healthy Skin Show that there is a distinct link between the microbiomes that live in your gut and your skin.

I suspect from all my research and work within my clinical practice that an overgrowth of certain gut bugs could potentially allow for an overgrowth elsewhere.

It’s not uncommon to discover Candida overgrowth in the gut while simultaneously complaining of fungal issues on the skin, nails, vagina, groin, mouth and throat, or even on the feet.

This is a significant point to keep in mind especially if you’re dealing with psoriasis.

If you recall, I’ve talked about researchers who’ve located bacterial DNA fragments in the blood of those with psoriasis.

And then there is the research on putrified protein breakdown products (fermented by gut bacteria) identified within psoriasis plaques.

Gut health and bacteria that live in the gut microbiome play a role when it comes to psoriasis… so why not yeast?

That’s why it should come as no surprise that a 2018 systemic review and meta-analysis paper found that the “prevalence of Candida spp. colonization was significantly higher in patients with psoriasis compared with the control group.”(7)

Woman holding her stomach

Inverse Psoriasis: Look In Your Gut For Clues

That’s why I firmly believe that it’s worthwhile to investigate what’s going on in the gut microbiome in cases of psoriasis.

My experience in clinical practice working with psoriasis clients has demonstrated gut dysbiosis, but also at times, gut infections that were hidden.

When I say that they were hidden, I mean that no one was looking for them.

It’s really uncommon for a dermatologist to ask you how you’re pooping (or if you have any other gut symptoms for that matter).

Though many psoriatic clients have GI complaints, some people don’t have any at all!

That doesn’t mean that it’s not worth taking a look because I’ve worked with plenty of clients spanning from psoriasis to eczema to dandruff and other skin issues who have ZERO gut issues, but had unfriendly gut microbiomes that were driving skin issues.

Stool testing can be really helpful, but keep in mind that it’s not always the best test if you’re looking for yeast.

That’s where urine organic acid testing shines — they pick up the waste products of yeast that tend to live in the small intestine.

Here’s my list of labs that I use with clients to help them dig into what’s going on under the surface!

Of course, if you need more help figuring out your next best steps, reach out and let me know. I work with clients worldwide!

I hope this episode is helpful for you to connect some dots especially if you’re struggling with inverse psoriasis.

It’s time to break your silence and let go of the shame you feel about IP. This is an important clue on your journey.

Not saying anything could cause you to suffer longer than you have to, so make sure to share this with your doctor.

If your doctor has prescribed anti-fungal creams or steroid creams mixed anti-fungal medication, digging deeper into a potential overgrowth of candida could be a great next step!

And if you know someone struggling with this issue, please share this episode because this could potentially help them break free of these rashes.

Leave your questions or comments on inverse psoriasis and candida below so we can continue this conversation!

Thank you so much for tuning in and I look forward to seeing you in the next episode!

Woman reaching for reference books in library

REFERENCES

  1. https://www.psoriasis.org/about-psoriasis/types/inverse
  2. https://www.dovepress.com/inverse-psoriasis-from-diagnosis-to-current-treatment-options-peer-reviewed-fulltext-article-CCID
  3. https://www.medicalnewstoday.com/articles/314259
  4. https://www.visualdx.com/visualdx/diagnosis/inverse+psoriasis?diagnosisId=54511&moduleId=102
  5. https://www.dovepress.com/inverse-psoriasis-from-diagnosis-to-current-treatment-options-peer-reviewed-fulltext-article-CCID
  6. https://jcadonline.com/erythrasma-inverse-psoriasis/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5960518/

One study found that 56.6% of Inverse Psoriasis rashes had Corynebacterium minutissimum present making symptoms worse.