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Dermbits

Regarding oral candidiasis, how has this been managed and has it required discontinuation of the medication?  

Psoriasis

Because oral candidiasis emerged as the single side effect attributable to bimikizumab, there are now guidelines published on how to deal with it. Let me say, first of all, that fluconazole, actually as a single dose, is available in much of the world. I know that I was traveling in the UK and I saw in the drugstore, it's over the counter, available without prescription. A single pill is enough to adequately treat vulvo vaginal candidiasis. The other alternatives that have been used have been topical antifungals like mycostatin or myconazole, and there are a variety of them. But the oral fluconazole is very easy in terms of oral candidiasis. For years, I would treat patients with a single dose of fluconazole and it always worked. Recently, guidelines have been published recommending that oral fluconazole be used at a dose of 100 to 200 milligrams daily, depending on the size of the patient, and daily for seven days. And so that's become the new regimen that I use. But again, I've actually never had a patient fail three daily doses of fluconazole. I will say that there are other treatments that have been used historically and still are certainly acceptable for use in patients with mild disease. So, for example, oral mycostatin is a treatment that has been used for decades to treat oral thrush.