Deep cutaneous fungal infections in solid-organ transplant recipients.
Adolescent
Adult
Aged
Antifungal Agents
/ therapeutic use
Dermatologic Surgical Procedures
Dermatomycoses
/ epidemiology
Female
Graft Rejection
/ immunology
Humans
Hyphae
/ isolation & purification
Immunocompromised Host
Immunosuppressive Agents
/ adverse effects
Male
Middle Aged
Organ Transplantation
/ adverse effects
Phaeohyphomycosis
/ epidemiology
Prevalence
Retrospective Studies
Skin
/ immunology
Transplant Recipients
/ statistics & numerical data
Young Adult
antifungal treatment
deep cutaneous fungal infection
phaeohyphomycosis
solid-organ transplant recipients
Journal
Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
16
07
2019
revised:
23
12
2019
accepted:
31
12
2019
pubmed:
14
1
2020
medline:
25
2
2021
entrez:
14
1
2020
Statut:
ppublish
Résumé
Deep cutaneous fungal infections (DCFIs) are varied in immunosuppressed patients, with few data for such infections in solid-organ transplant recipients (s-OTRs). To determine DCFI diagnostic characteristics and outcome with treatments in s-OTRs. A 20-year retrospective observational study in France was conducted in 8 primary dermatology-dedicated centers for s-OTRs diagnosed with DCFIs. Relevant clinical data on transplants, fungal species, treatments, and outcomes were analyzed. Overall, 46 s-OTRs developed DCFIs (median delay, 13 months after transplant) with predominant phaeohyphomycoses (46%). Distribution of nodular lesions on limbs and granulomatous findings on histopathology were helpful diagnostic clues. Treatments received were systemic antifungal therapies (48%), systemic antifungal therapies combined with surgery (28%), surgery alone (15%), and modulation of immunosuppression (61%), leading to complete response in 63% of s-OTRs. Due to the retrospective observational design of the study. Phaeohyphomycoses are the most common DCFIs in s-OTRs. Multidisciplinary teams are helpful for optimal diagnosis and management.
Sections du résumé
BACKGROUND
BACKGROUND
Deep cutaneous fungal infections (DCFIs) are varied in immunosuppressed patients, with few data for such infections in solid-organ transplant recipients (s-OTRs).
OBJECTIVE
OBJECTIVE
To determine DCFI diagnostic characteristics and outcome with treatments in s-OTRs.
METHODS
METHODS
A 20-year retrospective observational study in France was conducted in 8 primary dermatology-dedicated centers for s-OTRs diagnosed with DCFIs. Relevant clinical data on transplants, fungal species, treatments, and outcomes were analyzed.
RESULTS
RESULTS
Overall, 46 s-OTRs developed DCFIs (median delay, 13 months after transplant) with predominant phaeohyphomycoses (46%). Distribution of nodular lesions on limbs and granulomatous findings on histopathology were helpful diagnostic clues. Treatments received were systemic antifungal therapies (48%), systemic antifungal therapies combined with surgery (28%), surgery alone (15%), and modulation of immunosuppression (61%), leading to complete response in 63% of s-OTRs.
LIMITATIONS
CONCLUSIONS
Due to the retrospective observational design of the study.
CONCLUSIONS
CONCLUSIONS
Phaeohyphomycoses are the most common DCFIs in s-OTRs. Multidisciplinary teams are helpful for optimal diagnosis and management.
Identifiants
pubmed: 31931081
pii: S0190-9622(20)30043-8
doi: 10.1016/j.jaad.2019.12.064
pii:
doi:
Substances chimiques
Antifungal Agents
0
Immunosuppressive Agents
0
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
455-462Informations de copyright
Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.