Skin cancers in Italian lung transplant recipients: Incidence and risk factors analysis.

Only a few studies reported the incidence and risk factors of skin cancers in lung transplant recipients. The aim of this study was to determine the cumulative incidence of skin cancers in a cohort of patients undergoing lung transplantation and to define predictors of their development. About 247 consecutive patients receiving lung transplantation at the Thoracic Surgery Unit of University Hospital of Padova between May 1995 and October 2016 were studied. Cumulative incidence of skin cancers was estimated considering death as a competing event. The effect of potential predictors was evaluated with univariate and multivariable Cox models for competing risks. About 37 (15.0%) patients developed skin tumors. The cumulative incidence of any skin cancer was 14.2% at 5 years, 21.4% at 10 years, and 24.3% at 15 years posttransplantation. Age at transplantation, male gender, phototype II, and voriconazole use were independent risk factors for development of squamous cell carcinoma. Only male gender and phototype II were independent risk factors for development of basal cell carcinoma. Since lung transplant recipients have a greater risk of developing skin cancers, the management of these patients needs a multidisciplinary approach, in which dermatologists and transplant physicians have a primary role.

Peristomal allergic contact dermatitis caused by ostoma pastes and role of Gantrez ES-425.

BACKGROUND: Peristomal allergic contact dermatitis is an emerging problem and contact sensitization is probably more common than previously thought. Our objective was to identify sensitization to the most common topical equipment for ostomy in patients with history of peristomal dermatitis. METHODS: Twenty-six patients with suspected peristomal contact dermatitis were patch tested with our standard series and with products for stoma care (adhesive pastes, powders, adhesive skin barriers). Thirteen patients and 20 volunteers were also patch tested with Gantrez ES-425, which is a common component of adhesive pastes. RESULTS: Eighteen patients showed one or more positive reactions, 12 to one or more of the most commonly used adhesive pastes. Ten out of 13 patients tested to Gantrez ES-425 had a positive reaction. CONCLUSIONS: Allergic contact dermatitis of the peristomal area is probably more common than previously reported. Patch testing is the method of choice to determine sensitization to products for stoma care, and Gantrez ES-425 should be considered for patch testing.

Livedoid eruption in a patient affected by T-γδ large granular lymphocyte leukaemia.

Livedo is an ischaemic dermopathy characterised by a reddish-blue to violaceous mottling of the skin with a net-like reticular appearance. Livedo has been described in association with several medical conditions including lymphoproliferative disorders. Here, we describe the case of a 60-year-old woman who was presented with asymptomatic and persistent livedoid eruption on her trunk, lower and upper extremities as manifestation of an indolent form of T-γδ large granular lymphocyte leukaemia. To the best of our knowledge, this is the first report describing the association between livedo reticularis and T-γδ large granular lymphocyte leukaemia. It is plausible that a pathogenetic role of the neoplastic process is based on a cytotoxic antiendothelial activity.

Mycological visits requested in a tertiary referral center: what can be hiding behind a suspected skin mycosis?

BACKGROUND: Few studies have so far specifically addressed referrals for mycological visits to analyze the requests for mycological visits in a tertiary referral centre, with particular regard to the rate of true mycoses, the correlation between correct diagnostic hypothesis and specialization of the referring physicians, and the most frequently misdiagnosed dermatological disorders. METHODS: A number of 415 consecutive patients attending our Mycology Unit for suspected superficial fungal infections were enrolled. Final diagnosis was made on clinical features, history, microscopic and cultural analyses and, when necessary, histology. RESULTS: The results show that 118 patients (28.43%) were diagnosed to be affected with fungi, mainly dermatophytes (57%) and Candida (29%). Among nail referrals, onychoystrophies due to mechanical injuries and psoriasis were the most frequently misdiagnosed disorders. Eczema accounted for the main part of the suspected mycoses of glabrous skin, while tinea capitis was the most common referral for hair diseases. The rate of confirmed dermatomychosis was higher among patients referred by dermatologists than by other physicians. The majority of the study patients had undergone previous therapies, mainly antimycotics. CONCLUSIONS: Clinical assessment is often insufficient for diagnosing cutaneous mycoses. Mycological examination is advisable not only for a conclusive diagnosis but also to avoid unnecessary treatments. Nevertheless, clinical competence is relevant for correct suspicion of dermatomycosis.