BACKGROUND The increasing in the number of kidney transplant recipients has favored, more frequently than before, the emergence of dermatoses and warranted their study through subsequent publications.
OBJECTIVES to evaluate the frequency of dermatoses in kidney transplant recipients.
METHODS kidney transplant recipients with suspected dermatoses between March 1st 2009 and June 30th 2010.
RESULTS 53 patients (28 males and 25 females), aged between 22 and 69 (mean age = 45 years) were evaluated. Most of them came from the cities of Ceilândia, Samambaia and São Sebastião/DF, and had already been transplanted for 5 to 10 years before (37.7%); 62.3% were recipients of living donors and 83% were prednisone-treated. The most prevalent dermatoses were of fungal (45.3%) and viral (39.6%) etiologies. Among the non-melanoma malignant neoplasms, the basal cell carcinoma prevailed (six cases), in spite of the low incidence. Concerning fungal dermatoses, 12 cases of onychomycosis, five of pityriasis versicolor and four of pityrosporum folliculitis were reported. For diagnosis, in most cases (64.2%), laboratory examinations (mycological and histopathological) were performed.
CONCLUSION cutaneous manifestations in kidney transplant recipients are generally secondary to immunosuppression. The infectious dermatoses, especially those of fungal origin, are frequently found in kidney transplant recipients and their occurrence increases progressively according to the time elapsed from the transplantation, which makes follow-up important.
Chromoblastomycosis is a chronic fungal infection of the epidermis, dermis and
subcutaneous tissue, in which the most common etiologic agent in Brazil is
Fonsecaea pedrosoi. In more advanced cases we found many
difficulties in their treatment, and therefore, we report a case of extensive
and severe chromoblastomycosis, with therapeutical failure of first choice
treatments, but good response to voriconazole.
On rare occasions, skin lesions are the first local of metastatic manifestation
of internal malignancies. In case of no previous diagnosis of these tumors, the
approach of suspicious skin lesions becomes a challenge, especially in
differentiating cutaneous metastases and adnexal primary neoplasms. Currently,
besides epidemiologic, dermoscopic and histopathologic aspects, the evaluation
also integrates immunohistochemical exams and cell markers such as p40 and p63,
highly specific for skin metastases. This article describes the case of
cutaneous metastases as the sole obvious sign of breast cancer in a previously
asymptomatic woman. The diagnosis was made by the finding of neoplastic cells in
the dermis and immunohistochemistry compatible with ductal carcinoma.
Cryptococcosis is a fungal infection of opportunistic behavior that is unusual in
immunocompetent patients. We report a rare case of disseminated cryptococcosis
with cutaneous involvement in an immunocompetent individual. During
hospitalization, Cryptococcus gattii was isolated from skin
lesions, lung and spinal fluid. The diagnosis of disseminated
cryptococcosis was confirmed and treatment was established.
The patient showed improvement. Due to the probable clinical severity of the
disease and the possibility that skin lesions may be the first manifestation of
this illness, prompt diagnosis must be established and treatment provided.
The granulomatosis with polyangiitis, initially known as Wegener's granulomatosis, is
a small and medium vessels vasculitis. It's classic form presents a triad:
necrotizing granuloma of respiratory tract, necrotizing cutaneous vasculitis and
glomerulonephritis. This vasculitis has cytoplasmic antineutrophil antibodies as
signal. This work illustrates a case, of multisystemic rare disease, in which the
segment and treatment were considered satisfactory for symptoms remission.
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