They are delicate fish that don't respond well to stress. Once established in an aquarium they can thrive (and usually dominate).
But the moment they are stressed they are very susceptible to any kind of infection.
I had one in my fish only tank years ago. I had the fish for 6-7 years and the fish was constantly covered with something. Lots of other fish in the tank who were all clean but the Powder blue, who was over an inch thick, could go from perfectly clean to ich covered, to slime covered, to clean, to black ich, to whatever kinds of things you can imagine. I ran ozone on the tank, and tried all kinds of medications, but nothing worked and the fish just kept swimming and eating like a horse.
Dave B