tacrolimus and Cellulitis

Topics: Adalimumab; Adult; Anti-Inflammatory Agents; Breast; Cellulitis; Crohn Disease; Diagnosis, Differential; Female; Groin; Humans; Immunosuppressive Agents; Recurrence; Skin Diseases; Tacrolimus; Treatment Outcome

Topics: Cellulitis; Dermatitis; Dermatomyositis; Facial Dermatoses; Humans; Immunosuppressive Agents; Impetigo; Lupus Erythematosus, Discoid; Ointments; Psoriasis; Rosacea; Tacrolimus

Skin and soft tissue infection (SSTI) is the most common of infectious diseases with high morbidity and mortality. However, the clinical characteristics of SSTI in patients with nephrotic syndrome (NS), especially in those patients who received immunosuppressive therapy, are still lacking. The present study was conducted to investigate the clinical characteristics and outcomes of SSTI in patients with NS.. A retrospective study was carried out among the patients diagnosed with NS and SSTI, who have priorly received or currently have been receiving immunosuppressive therapy between April 2011 and January 2019; the clinical profile included patient's baseline characteristics, clinical presentation, microbiological findings, treatment, and prognosis.. A total of 70 patients were analyzed. Results showed that more than half of the patients were under 35 years old, and moderate infection was the most common type of SSTI. Leg and cellulitis were the most common site of lesion and the typical clinical manifestation of SSTI, respectively. Patients in the severe infection group have a higher level of procalcitonin (PCT) and C-reactive protein (CRP), while a lower level of albumin, CD4. Patients with NS and SSTI usually showed a satisfying outcome with proper anti-infection treatment, but severe SSTI can be life-threatening.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; C-Reactive Protein; CD4 Lymphocyte Count; CD8-Positive T-Lymphocytes; Cellulitis; Child; Cyclophosphamide; Female; Humans; Immunosuppression Therapy; Immunosuppressive Agents; Leg; Male; Middle Aged; Nephrotic Syndrome; Prednisone; Procalcitonin; Retrospective Studies; Serum Albumin; Severity of Illness Index; Soft Tissue Infections; Tacrolimus; Young Adult

Topics: Antifungal Agents; Bronchiolitis; Cellulitis; Cryptococcosis; Female; Humans; Immunocompromised Host; Lupus Erythematosus, Systemic; Middle Aged; Prednisolone; Tacrolimus

Wells syndrome (WS) or eosinophilic cellulitis is a rare, idiopathic, inflammatory dermatosis. The typical clinical presentation is urticarial plaque without preferential location that usually heals without scarring. We present a 62-year-old man with history of lung cancer that had undergone a right superior lobectomy 12 months previously. The patient had a relapsing dermatosis beginning about 6 months before the diagnosis of the lung cancer, characterised by pruritic, erythematous plaques located on the trunk and arms. These lesions spontaneously resolved within a few weeks without scarring. A skin biopsy revealed findings compatible with WS. Several diseases have been associated with WS. These include haematological diseases, fungal, parasitic and viral infections, drug reactions and rarely non-haematological malignancies. We present a case of this rare syndrome in a patient with history of lung cancer that we believe acted as a triggering event. To our knowledge, this is the second case reporting this association.

Topics: Administration, Topical; Biopsy; Cellulitis; Clobetasol; Dermatologic Agents; Eosinophilia; Humans; Loratadine; Lung Neoplasms; Male; Middle Aged; Recurrence; Skin Diseases; Tacrolimus; Treatment Outcome

Nontuberculous mycobacterial infections can often occur in individuals with adequate immune function. Such infections typically have cutaneous involvement and are caused by rapidly growing mycobacterium. Other nontuberculous mycobacteria species, like Mycobacterium haemophilum, almost always present as opportunistic infections occurring in severely immunocompromised hosts. Here, we present a complicated and protracted course of diagnosing M. haemophilum lower extremity cutaneous infection in a matched-unrelated donor stem cell transplant recipient.

Topics: Anti-Bacterial Agents; Biopsy; Cellulitis; Ciprofloxacin; Clarithromycin; Female; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Immunocompromised Host; Immunosuppression Therapy; Immunosuppressive Agents; Leukemia, Myeloid, Acute; Lower Extremity; Middle Aged; Mycobacterium haemophilum; Mycobacterium Infections, Nontuberculous; Opportunistic Infections; Rifabutin; Tacrolimus; Unrelated Donors

Topics: Anti-Inflammatory Agents; Calcineurin Inhibitors; Cellulitis; Eosinophilia; Humans; Male; Middle Aged; Prednisolone; Recurrence; Tacrolimus

A 72-year-old man presented with a 1-month history of a rash. The eruption had previously been successfully treated with oral corticosteroids (prednisolone 30 mg/day) and antihistamines on two previous occasions, but recurred several days after stopping treatment. On examination, multiple, indurated, round to annular erythematous plaques were found on the trunk and limbs. Histological examination revealed interstitial oedema, a dense infiltrate of eosinophils in the dermis, and flame figure formation. These results led us to the diagnosis of eosinophilic cellulitis. Treatment with oral corticosteroids (prednisolone 15 mg/day) was unsuccessful. Four weeks after the start of oral tacrolimus 1 mg/day, the eruption completely resolved.

Topics: Administration, Oral; Aged; Cellulitis; Eosinophilia; Humans; Immunosuppressive Agents; Male; Recurrence; Tacrolimus; Treatment Outcome

We describe two male patients with ulcerative colitis and refractory pyoderma gangrenosum including periorbital phlegmona in one case. Both patients were successfully managed with low dose oral tacrolimus (0.1 mg/kg bodyweight per day). Serum trough levels were closely monitored and maintained between 4 and 6 ng/mL. A rapid response was noted in both cases. Complete non-scarring skin restitution without side effects was accomplished in both cases. Low dose oral tacrolimus provides a valuable alternative treatment option for IBD patients with refractory pyoderma gangrenosum.

Topics: Adult; Cellulitis; Colitis, Ulcerative; Humans; Immunosuppressive Agents; Male; Orbital Diseases; Pyoderma Gangrenosum; Tacrolimus; Treatment Outcome