Deep cutaneous fungal infections in solid-organ transplant recipients.
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
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.
Link to DOI:https://www.doi.org/10.1016/j.jaad.2019.12.064