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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.Le texte complet de cet article est disponible en PDF.
Le texte complet de cet article est disponible en PDF.
Key words : antifungal treatment, deep cutaneous fungal infection, phaeohyphomycosis, solid-organ transplant recipients
Abbreviations used : CNI, DCFI, IS, MMF, s-OTR
| Funding sources: Supported by Skin and Organ Transplantation Group of the French Society of Dermatology (Groupe Peau et Greffe d'organe de la Société Française de Dermatologie).
| Disclosure: Dr Lebbé received research grants or honoraria from Roche, Bristol-Myers Squibb, Merck Sharpe & Dohme, GlaxoSmithKline, Novartis, and Amgen outside the submitted work. Drs Galezowski, Delyon, Le Cleach, Guégan, Ducroux, Alanio, Lastennet, Moguilet, Dadban, Leccia, Pelletier, Francès, and Barete have no conflicts of interest to declare.
| IRB approval status: Informed consent in accordance with the Declaration of Helsinki.