Increased Fungal Infections while using Emerging Therapies (Biologics and Small-molecule Inhibitors) for Treating Skin Diseases: A Review

Biologics, such as tumor necrosis factor-α and interleukin inhibitors, are commonly used for treating immunological skin diseases, including psoriasis, psoriatic arthritis, and atopic dermatitis. The cluster of differentiation inhibitors and immune checkpoint inhibitors has also been used for treating bullous disorders and melanoma, respectively. Other small-molecule inhibitors, such as JAK inhibitors, have been introduced for treating atopic dermatitis and alopecia areata. Hence, given the importance of cytokines and small molecules in antifungal immunity, using these new treatments are proposed to increase the risk of fungal infections. Thus, this review presents an overview of the reported incidences and possible mechanisms of fungal infections related to the use of biologics, including small-molecule inhibitors used for dermatological treatments.