ABSTRACT
BACKGROUND: Superficial and deep fungal infections are more frequent in transplant recipients primarily because of the failure of cell-mediated immunity and lesser amount of antigen-presenting Langerhans cells in their epidermis. Here, we report seven cases of post-renal transplant subcutaneous phaeohyphomycosis, all of which manifested within 1 year after transplantation and were unresponsive to prolonged courses of itraconazole. This is the first case series, to our knowledge, of phaeohyphomycosis in transplant recipients in India. METHOD: We performed a retrospective review of cases of phaeohyphomycosis among kidney transplant recipients for type of transplant, immunosuppression, histopathology, and treatment, with prospective follow-up of healed lesion. RESULTS: An overall incidence of 8.3% was noted, with a median duration of approximately 6 months post transplant to the onset of skin lesion. None of the lesions responded to itraconazole alone and 6/7 lesions were surgically excised. Histopathology showed various lesions and culture could isolate Neocytalidium and Exophiala jeanselmi in two cases. CONCLUSION: Dematiaceous fungi are increasingly implicated in cutaneous lesions in transplant recipients. Histopathology and surgical excision are the appropriate tools for diagnosis and treatment, respectively.
Subject(s)
Antifungal Agents/therapeutic use , Dermatomycoses/epidemiology , Immunosuppression Therapy/adverse effects , Kidney Transplantation/adverse effects , Phaeohyphomycosis/epidemiology , Adolescent , Adult , Dermatomycoses/drug therapy , Dermatomycoses/microbiology , Dermatomycoses/pathology , Exophiala/isolation & purification , Female , Follow-Up Studies , Humans , Immunosuppression Therapy/methods , Incidence , India/epidemiology , Itraconazole/therapeutic use , Male , Middle Aged , Phaeohyphomycosis/drug therapy , Phaeohyphomycosis/microbiology , Phaeohyphomycosis/pathology , Prospective Studies , Retrospective Studies , Skin/microbiology , Skin/pathology , Transplant Recipients/statistics & numerical data , Treatment Outcome , Young AdultSubject(s)
Breast Implantation/methods , Breast Implants , Breast Implantation/instrumentation , Female , HumansABSTRACT
Earlobe piercing is a common office room procedure done by a plastic surgeon. Various methods of ear piercing have been described. In this article, we describe a novel method of laser ear piercing using the diode laser. An 18-year-old female patient underwent an ear piercing using a diode laser with a power of 2.0 W in continuous mode after topical local anaesthetic and pre-cooling. The diode laser was fast, safe, easy to use and highly effective way of ear piercing. The advantages we noticed while using the diode laser over conventional methods were more precision, minimal trauma with less chances of hypertrophy and keloids, no bleeding with coagulation effect of laser, less time taken compared to conventional method and less chance of infection due to thermal heat effect of laser.
