ABSTRACT
Aims: Patients with hematological or solid organ malignancies are susceptible to various skin disorders. This study described the cutaneous problems related to the underlying diseases or their management in hematology and oncology inpatients. Methods: In this retrospective study with a cross-sectional analysis, we examined the medical records of inpatients with hematologic or solid organ malignancy who consulted the dermatology department from January 2018 through March 2021. Sociodemographic characteristics, medical history and comorbidities, cancer type, and dermatological findings and diagnoses were noted. Patients who have consulted the outpatient clinic and those with inadequate medical records were excluded. Results: The study included 200 patients (age, mean±standard deviation, minimum-maximum: 51.4±18.2, 18-89 years;female 51%). Most of the consultations were from the internal medicine clinic (26.4%), followed by the hematology and oncology clinics (12.5%). A quarter of the patients had acute myeloid leukemia, the most frequent disease among hematological malignancies. Breast cancer (7%) and testis cancer (7%) were the most common solid organ malignancies. The most common dermatological diagnoses were cutaneous infections (33.5%) and drug reactions (13.5%). Skin biopsies were performed in 19.5% (n=39) of the patients. The evaluation of the patient by a dermatologist for a cutaneous symptom or finding led to modifications of disease management in 67 patients (33.7%). Conclusions: Dermatology consultations are frequently required in hematological or solid organ malignancies. A successful evaluation of skin manifestations in these patients may improve the quality of care in this vulnerable population.
ABSTRACT
Psoriasis is a chronic inflammatory skin disease that is characterized by well-demarcated erythematous plaques with a silver scale. Although many new and emerging therapeutic agents are often sufficient to control the disease, there is still a need for alternative treatment options in challenging cases. Extracorporeal photopheresis (ECP) has been applied to many T-cell-mediated diseases to restore immune homeostasis and treat psoriasis effectively. In this paper, we present a psoriasis patient who did not respond to methotrexate, narrowband ultraviolet B, or acitretin. Because of a diagnosis of non-Hodgkin lymphoma, the patient had contraindications for cyclosporine, fumaric acid esters, and biologics but achieved remission with a total of 12 sessions of ECP in two and a half months. Although exacerbation was recorded after polymerase chain reaction (PCR) confirmed coronavirus 2019 (COVID-19) disease infection at the end of the first month, scores from the psoriasis area severity index (PASI) and dermatological life quality index (DLQI) were regressed significantly within two and a half months. ECP seems to provide an effective and rapid response for psoriasis and should be considered for psoriasis patients who fail to respond or have contraindications to existing treatments.