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CASE REPORT
A STAT1-gain-of-function mutation causing Th17 deficiency with chronic mucocutaneous candidiasis, psoriasiform hyperkeratosis and dermatophytosis
  1. Jakob Nielsen1,
  2. Emil Kofod-Olsen2,
  3. Eva Spaun2,
  4. Carsten S Larsen3,
  5. Mette Christiansen4,
  6. Trine Hyrup Mogensen5
  1. 1Department of Dermatology, Aarhus University Hospital, Aarhus N, Denmark
  2. 2Institute of Pathology, Aarhus University Hospital, Aarhus N, Denmark
  3. 3Department of Infectious Diseases, Aarhus University Hospital, Aarhus N, Denmark
  4. 4Department of Clinical Immunology, Aarhus University Hospital, Aarhus N, Denmark
  5. 5Aarhus University Hospital, Aarhus N, Denmark
  1. Correspondence to Dr Trine Hyrup Mogensen, trinmoge{at}rm.dk

Summary

During recent years, inborn errors of human IL-17 immunity have been demonstrated to underlie primary immunodeficiencies with chronic mucocutaneous candidiasis (CMC). Various defects in receptors responsible for sensing of Candida albicans or downstream signalling to IL-17 may lead to susceptibility to Candida infection. While CMC is common in patients with profound T cell immunodeficiencies, CMC is also recognised as part of other immunodeficiencies in syndromic CMC, or as relatively isolated CMC disease. We describe a 40-year-old woman with a clinical picture involving cutaneous bacterial abscesses, chronic oral candidiasis and extensive dermatophytic infection of the feet. By whole exome sequencing, we identified a STAT1-gain-of-function mutation. Moreover, the patient's peripheral blood mononuclear cells displayed severely impaired Th17 responses. The patient was treated with antifungals and prophylactic antibiotics, which led to resolution of the infection. We discuss the current knowledge within the field of Th17 deficiency and the pathogenesis and treatment of CMC.

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