Deep cutaneous fungal infections in solid-organ transplant recipients
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...
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| Veröffentlicht in: | Journal of the American Academy of Dermatology 2020-08, Vol.83 (2), p.455-462 |
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| creator | Galezowski, Agnès Delyon, Julie Le Cleach, Laurence Guégan, Sarah Ducroux, Emilie Alanio, Alexandre Lastennet, Diane Moguelet, Philippe Dadban, Ali Leccia, Marie Thérèse Le Pelletier, François Francès, Camille Lebbé, Céleste Barete, Stéphane |
| description | 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.
[Display omitted] |
| doi_str_mv | 10.1016/j.jaad.2019.12.064 |
| format | Article |
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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.
[Display omitted]</description><identifier>ISSN: 0190-9622</identifier><identifier>EISSN: 1097-6787</identifier><identifier>DOI: 10.1016/j.jaad.2019.12.064</identifier><identifier>PMID: 31931081</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Antifungal Agents ; Antifungal Agents - therapeutic use ; antifungal treatment ; deep cutaneous fungal infection ; Dermatologic Surgical Procedures ; Dermatomycoses ; Dermatomycoses - epidemiology ; Dermatomycoses - immunology ; Dermatomycoses - microbiology ; Dermatomycoses - therapy ; Female ; Graft Rejection ; Graft Rejection - immunology ; Graft Rejection - prevention & control ; Humans ; Hyphae ; Hyphae - isolation & purification ; Immunocompromised Host ; Immunosuppressive Agents ; Immunosuppressive Agents - adverse effects ; Life Sciences ; Male ; Middle Aged ; Organ Transplantation ; Organ Transplantation - adverse effects ; Phaeohyphomycosis ; Phaeohyphomycosis - epidemiology ; Phaeohyphomycosis - immunology ; Phaeohyphomycosis - microbiology ; Phaeohyphomycosis - therapy ; Prevalence ; Retrospective Studies ; Skin ; Skin - immunology ; Skin - microbiology ; solid-organ transplant recipients ; Transplant Recipients ; Transplant Recipients - statistics & numerical data ; Young Adult</subject><ispartof>Journal of the American Academy of Dermatology, 2020-08, Vol.83 (2), p.455-462</ispartof><rights>2020 American Academy of Dermatology, Inc.</rights><rights>Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.</rights><rights>Attribution - NonCommercial</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c434t-a9afcabd36f126d80e0f29e636e1ee396fbfad035072a556eb3fe16383056c343</citedby><cites>FETCH-LOGICAL-c434t-a9afcabd36f126d80e0f29e636e1ee396fbfad035072a556eb3fe16383056c343</cites><orcidid>0000-0001-9726-3082 ; 0000-0002-4557-3377 ; 0000-0003-1996-6406 ; 0000-0002-8932-7258</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jaad.2019.12.064$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,778,782,883,3539,27911,27912,45982</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31931081$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-03492502$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Galezowski, Agnès</creatorcontrib><creatorcontrib>Delyon, Julie</creatorcontrib><creatorcontrib>Le Cleach, Laurence</creatorcontrib><creatorcontrib>Guégan, Sarah</creatorcontrib><creatorcontrib>Ducroux, Emilie</creatorcontrib><creatorcontrib>Alanio, Alexandre</creatorcontrib><creatorcontrib>Lastennet, Diane</creatorcontrib><creatorcontrib>Moguelet, Philippe</creatorcontrib><creatorcontrib>Dadban, Ali</creatorcontrib><creatorcontrib>Leccia, Marie Thérèse</creatorcontrib><creatorcontrib>Le Pelletier, François</creatorcontrib><creatorcontrib>Francès, Camille</creatorcontrib><creatorcontrib>Lebbé, Céleste</creatorcontrib><creatorcontrib>Barete, Stéphane</creatorcontrib><creatorcontrib>Skin and Organ Transplantation Group of the French Society of Dermatology</creatorcontrib><title>Deep cutaneous fungal infections in solid-organ transplant recipients</title><title>Journal of the American Academy of Dermatology</title><addtitle>J Am Acad Dermatol</addtitle><description>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.
[Display omitted]</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Antifungal Agents</subject><subject>Antifungal Agents - therapeutic use</subject><subject>antifungal treatment</subject><subject>deep cutaneous fungal infection</subject><subject>Dermatologic Surgical Procedures</subject><subject>Dermatomycoses</subject><subject>Dermatomycoses - epidemiology</subject><subject>Dermatomycoses - immunology</subject><subject>Dermatomycoses - microbiology</subject><subject>Dermatomycoses - therapy</subject><subject>Female</subject><subject>Graft Rejection</subject><subject>Graft Rejection - immunology</subject><subject>Graft Rejection - prevention & control</subject><subject>Humans</subject><subject>Hyphae</subject><subject>Hyphae - isolation & purification</subject><subject>Immunocompromised Host</subject><subject>Immunosuppressive Agents</subject><subject>Immunosuppressive Agents - adverse effects</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Organ Transplantation</subject><subject>Organ Transplantation - adverse effects</subject><subject>Phaeohyphomycosis</subject><subject>Phaeohyphomycosis - epidemiology</subject><subject>Phaeohyphomycosis - immunology</subject><subject>Phaeohyphomycosis - microbiology</subject><subject>Phaeohyphomycosis - therapy</subject><subject>Prevalence</subject><subject>Retrospective Studies</subject><subject>Skin</subject><subject>Skin - immunology</subject><subject>Skin - microbiology</subject><subject>solid-organ transplant recipients</subject><subject>Transplant Recipients</subject><subject>Transplant Recipients - statistics & numerical data</subject><subject>Young Adult</subject><issn>0190-9622</issn><issn>1097-6787</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFOwzAMhiMEYmPwAhxQrxxanKRNF4nLBIMhTeIC5yhLnZGpS6umncTbk2qwIydb9vdb8kfILYWMAhUPu2yndZUxoDKjLAORn5EpBVmmopyX52QaF5BKwdiEXIWwAwCZ8_KSTDiVnMKcTsnyGbFNzNBrj80QEjv4ra4T5y2a3jU-xDYJTe2qtOm22id9p31oa-37pEPjWoe-D9fkwuo64M1vnZHPl-XH0ypdv7--PS3Wqcl53qdaamv0puLCUiaqOSBYJlFwgRSRS2E3VlfACyiZLgqBG26RCj7nUAjDcz4j98e7X7pWbef2uvtWjXZqtVircQY8l6wAdqCRZUfWdE0IHdpTgIIa_amdGv2p0Z-iTEV_MXR3DLXDZo_VKfInLAKPRwDjmweHnQomKjBYuaijV1Xj_rv_AzjJgTM</recordid><startdate>202008</startdate><enddate>202008</enddate><creator>Galezowski, Agnès</creator><creator>Delyon, Julie</creator><creator>Le Cleach, Laurence</creator><creator>Guégan, Sarah</creator><creator>Ducroux, Emilie</creator><creator>Alanio, Alexandre</creator><creator>Lastennet, Diane</creator><creator>Moguelet, Philippe</creator><creator>Dadban, Ali</creator><creator>Leccia, Marie Thérèse</creator><creator>Le Pelletier, François</creator><creator>Francès, Camille</creator><creator>Lebbé, Céleste</creator><creator>Barete, Stéphane</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>1XC</scope><scope>VOOES</scope><orcidid>https://orcid.org/0000-0001-9726-3082</orcidid><orcidid>https://orcid.org/0000-0002-4557-3377</orcidid><orcidid>https://orcid.org/0000-0003-1996-6406</orcidid><orcidid>https://orcid.org/0000-0002-8932-7258</orcidid></search><sort><creationdate>202008</creationdate><title>Deep cutaneous fungal infections in solid-organ transplant recipients</title><author>Galezowski, Agnès ; 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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.
[Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31931081</pmid><doi>10.1016/j.jaad.2019.12.064</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-9726-3082</orcidid><orcidid>https://orcid.org/0000-0002-4557-3377</orcidid><orcidid>https://orcid.org/0000-0003-1996-6406</orcidid><orcidid>https://orcid.org/0000-0002-8932-7258</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0190-9622 |
| ispartof | Journal of the American Academy of Dermatology, 2020-08, Vol.83 (2), p.455-462 |
| issn | 0190-9622 1097-6787 |
| language | eng |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Adolescent Adult Aged Antifungal Agents Antifungal Agents - therapeutic use antifungal treatment deep cutaneous fungal infection Dermatologic Surgical Procedures Dermatomycoses Dermatomycoses - epidemiology Dermatomycoses - immunology Dermatomycoses - microbiology Dermatomycoses - therapy Female Graft Rejection Graft Rejection - immunology Graft Rejection - prevention & control Humans Hyphae Hyphae - isolation & purification Immunocompromised Host Immunosuppressive Agents Immunosuppressive Agents - adverse effects Life Sciences Male Middle Aged Organ Transplantation Organ Transplantation - adverse effects Phaeohyphomycosis Phaeohyphomycosis - epidemiology Phaeohyphomycosis - immunology Phaeohyphomycosis - microbiology Phaeohyphomycosis - therapy Prevalence Retrospective Studies Skin Skin - immunology Skin - microbiology solid-organ transplant recipients Transplant Recipients Transplant Recipients - statistics & numerical data Young Adult |
| title | Deep cutaneous fungal infections in solid-organ transplant recipients |
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