Deep cutaneous fungal infections in solid-organ transplant recipients.

Deep cutaneous fungal infections in solid-organ transplant recipients.

Author:

Galezowski A, Delyon J, Le Cleach L, Guégan S, Ducroux E, Alanio A, Lastennet D, Moguelet P, Dadban A, Leccia MT, Le Pelletier F, Francès C, Lebbé C, Barete S; Skin and Organ Transplantation Group of the French Society of Dermatology.

Date: 14 April 2020

Abstract:

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:

To determine DCFI diagnostic characteristics and outcome with treatments in s-OTRs.

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:

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:

Due to the retrospective observational design of the study.

CONCLUSIONS:

Phaeohyphomycoses are the most common DCFIs in s-OTRs. Multidisciplinary teams are helpful for optimal diagnosis and management.

Link to DOI:

https://www.doi.org/10.1016/j.jaad.2019.12.064


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