IL-17 matters for mucosal defence against Candida, which is why oral and genital candidiasis follows IL-17 blockade. A history of recurrent thrush, poorly controlled diabetes, denture use or inhaled steroids tips the balance toward an IL-23 inhibitor. Most episodes are mild and treatable without stopping the biologic.
- Ask about oral, genital and skin-fold candidiasis in the past year.
- Check HbA1c; diabetes raises candidiasis risk independently.
- Warn patients starting an IL-17 inhibitor what thrush looks like.
- Treat mild episodes topically and continue the biologic.
Why it matters
A two-minute history can steer biologic choice away from a predictable side effect.
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