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Eur J Dermatol ; 22(5): 651-7, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23008283

RESUMO

Data on post-graft cutaneous cryptococcosis (CC) are rare. The objective was to delineate the epidemiological, clinical, diagnostic, therapeutic features of CC in organ transplant recipients. We compared cases from a cohort of 3,670 transplanted adults with cases from a regional cryptococcosis registry including 122 patients. Four CC were diagnosed in the transplanted cohort (1‰) corresponding in the regional registry to 33% of the 12 cases of cryptococcosis after transplantation, while among the 110 non-grafted patients, only five cryptococcosis were cutaneous (4%). CC appeared as a single (3 patients) ulcer or nodule over 1cm in size in an uncovered body zone, on average 13 months post-graft. 3 patients had concomitant opportunistic infections or a recent increase in their immunosuppression. All CC after transplantation were localized exclusively to the skin, raising the question of the mode of contamination (through the skin or the lungs). Evidence of dissemination is difficult because of the poor sensitivity of diagnostic tests. Fluconazole was the treatment of choice in association with immunosuppressive treatment tapering.


Assuntos
Criptococose/diagnóstico , Criptococose/imunologia , Dermatomicoses/diagnóstico , Dermatomicoses/imunologia , Imunossupressores/efeitos adversos , Transplante de Órgãos/efeitos adversos , Adulto , Idoso , Antifúngicos/uso terapêutico , Criptococose/tratamento farmacológico , Criptococose/epidemiologia , Dermatomicoses/tratamento farmacológico , Dermatomicoses/epidemiologia , Feminino , Fluconazol/uso terapêutico , Humanos , Imunossupressores/administração & dosagem , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Estudos Retrospectivos
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