Blastocystis, urticaria, and skin disorders: review of the current evidences

• Published in: European journal of clinical microbiology & infectious diseases Vol. 39; no. 6; pp. 1027 - 1042
• Main Authors: Bahrami, Fares, Babaei, Erfan, Badirzadeh, Alireza, Riabi, Tahereh Rezaei, Abdoli, Amir
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-06-2020; Springer Nature B.V
• Subjects: Antiprotozoal Agents - therapeutic use; Asymptomatic infection; Asymptomatic Infections - therapy; Biomedical and Life Sciences; Biomedicine; Blastocystis; Blastocystis - classification; Blastocystis - genetics; Blastocystis - isolation & purification; Blastocystis Infections - complications; Blastocystis Infections - diagnosis; Blastocystis Infections - drug therapy; Case reports; Cross-sectional studies; Diagnostic systems; Disorders; Gastrointestinal symptoms; Genetic Variation; Humans; Identification methods; Infections; Internal Medicine; Intestinal Diseases, Parasitic - complications; Intestinal Diseases, Parasitic - diagnosis; Intestinal Diseases, Parasitic - drug therapy; Intestine; Itching; Lesions; Medical Microbiology; Metronidazole; Parasites; Paromomycin; Patients; Protozoa; Pruritus; Review; Skin diseases; Skin Diseases - diagnosis; Skin Diseases - drug therapy; Skin Diseases - parasitology; Tinidazole; Treatment Outcome; Urticaria; Urticaria - diagnosis; Urticaria - drug therapy; Urticaria - parasitology; Urticaria; Cutaneous lesions; Skin disorders; Blastocystis
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s10096-019-03793-8

Blastocystis
is one of the most common intestinal protozoan parasites worldwide, which is linked to cutaneous lesions and urticaria. In a setting of systematic review, the data on the association of
Blastocystis
infection with cutaneous lesions were searched in order to summarize the main clinical symptoms, diagnostic methods, treatment, and outcome of the patients. The search identified 28 eligible articles, including 12 cross-sectional studies and 16 case reports/case series (including 23 cases). A diverse spectrum of skin symptoms, mainly urticaria, rash, and itching, was reported from the studies. Of the 23 infected cases with the skin symptoms, gastrointestinal symptoms were reported from the 16 cases, whereas 7 cases with urticaria had asymptomatic infection. The most frequent subtypes were ST1, ST2, and ST3, respectively. Metronidazole, paromomycin, and tinidazole were the most prescribed drugs in patients with single
Blastocystis
infection. Notably, urticaria and other cutaneous symptoms of all treated patients were resolved after treatment. In conclusion, this study indicates that
Blastocystis
infection can be a neglected cause of urticaria and skin disorders. Since the treatment of
Blastocystis
infection is simple, screening and treatment of this infection should be considered in patients with urticaria and other skin disorders.