A patient taking secukinumab, a medication for psoriasis and joint inflammation, developed a rare fungal infection in their mouth called chronic hyperplastic candidiasis. This case report highlights an important side effect that doctors should watch for. Secukinumab works by blocking a protein in the immune system, which helps treat psoriasis but can sometimes make people more vulnerable to infections. The researchers reviewed similar cases and found that patients on this type of medication need careful monitoring by both their dermatologist and dentist to catch oral infections early and prevent serious complications.

The Quick Take

  • What they studied: Whether secukinumab, a newer psoriasis medication, can cause a rare fungal infection in the mouth
  • Who participated: One patient with psoriasis and joint arthritis who was being treated with secukinumab and developed an unusual mouth infection
  • Key finding: The patient developed chronic hyperplastic candidiasis (a rare fungal infection) while taking secukinumab, suggesting the medication may increase infection risk in the mouth
  • What it means for you: If you take secukinumab for psoriasis or arthritis, be aware of unusual mouth sores or white patches and report them to your doctor immediately. This is a rare side effect, but early detection is important. Always tell your dentist about any new medications you’re taking.

The Research Details

This is a case report, which means the researchers documented one patient’s experience in detail and then reviewed similar cases reported in medical literature. The patient had psoriasis and psoriatic arthritis and was being treated with secukinumab when they developed an unusual fungal infection in their mouth. The doctors performed a biopsy (took a small tissue sample) to confirm the diagnosis under a microscope. They then searched medical databases to find other similar cases and reviewed what was known about this type of infection and this medication.

Case reports are important for identifying rare side effects that might not show up in larger studies. Since this type of mouth infection is uncommon, a detailed case report helps doctors recognize the warning signs and understand how the medication might cause it. This information helps healthcare providers monitor patients more carefully.

This is a single case report, which is the lowest level of scientific evidence. However, it’s valuable because it documents a rare but serious side effect. The researchers strengthened their findings by reviewing the medical literature and consulting with specialists. The diagnosis was confirmed with a biopsy, which is the gold standard. The main limitation is that one case cannot prove the medication always causes this problem—it only suggests a possible connection that needs further study.

What the Results Show

One patient with psoriasis and joint arthritis developed a rare fungal infection in their mouth (chronic hyperplastic candidiasis) while taking secukinumab. The infection appeared as unusual white patches and growths on the mouth tissues. The diagnosis was confirmed by taking a tissue sample and examining it under a microscope, which showed fungal infection. The patient’s doctors believe the secukinumab weakened their immune system’s ability to fight fungal infections, making them vulnerable to this rare condition. The infection required specific antifungal treatment and close monitoring by both dental and medical specialists.

The researchers identified several other cases in medical literature where patients on similar immune-suppressing medications developed oral candidiasis (mouth fungal infections). They found that other factors can increase risk, including dry mouth, smoking, antibiotic use, vitamin deficiencies, and other immune system conditions. The researchers emphasized that dentists and doctors need to be aware of these potential side effects so they can catch them early.

Secukinumab is a newer type of medication that blocks a specific immune system protein (IL-17A). Previous research already showed that this class of medication can increase the risk of common oral infections like herpes and regular candidiasis. This case report adds to that knowledge by documenting a rarer, more serious form of fungal infection. It suggests that doctors should be more vigilant about monitoring the mouth health of patients taking these medications.

This is only one patient’s case, so we cannot say how common this side effect is. We don’t know if other patients on secukinumab have had similar problems that weren’t reported. The case doesn’t prove that secukinumab definitely caused the infection—other factors in this patient’s health may have contributed. Larger studies would be needed to understand how often this happens and who is at highest risk.

The Bottom Line

If you take secukinumab or similar immune-suppressing medications: (1) See your dentist regularly and tell them about your medication, (2) Watch for unusual white patches, sores, or growths in your mouth, (3) Report any mouth changes to your doctor immediately, (4) Maintain good oral hygiene, (5) Avoid smoking and excessive alcohol. These are precautions based on this case report and medical experience, not definitive proof that everyone will have problems.

This is most relevant for people taking secukinumab or similar IL-17A blocking medications for psoriasis, psoriatic arthritis, or other conditions. Dentists and dermatologists should be aware of this potential side effect. People with other risk factors (dry mouth, smoking, weakened immune systems) should be especially vigilant. This is less relevant for people not taking these medications, though the general principle of watching for unusual mouth changes applies to everyone.

In this case, the infection developed over time while the patient was on the medication. There’s no specific timeline for when this might occur—it could happen weeks or months after starting the medication. If you notice changes, they should be evaluated within days to a week, not months. Once treated, recovery depends on the specific antifungal treatment used and how quickly the infection was caught.

Want to Apply This Research?

  • If taking secukinumab or similar medications, use the app to set weekly reminders to check your mouth for any white patches, sores, unusual growths, or color changes. Take photos in consistent lighting to track any changes over time.
  • Add a monthly ‘oral health check-in’ to your app where you document any mouth symptoms and schedule regular dental appointments. Set reminders to inform your dentist about your current medications at each visit.
  • Create a symptom log in the app that tracks: date, location of any mouth changes, appearance (color, texture, size), associated pain or discomfort, and any other symptoms. Share this log with your healthcare providers at appointments to help them identify patterns early.

This case report describes a rare side effect in one patient and should not cause alarm. Most people taking secukinumab do not develop this infection. However, if you are taking secukinumab or similar medications and notice unusual changes in your mouth (white patches, sores, growths, or persistent discomfort), contact your doctor or dentist immediately. Do not stop taking your medication without consulting your healthcare provider. This information is educational and not a substitute for professional medical advice. Always discuss any concerns about your medications with your doctor or dermatologist.