tacrolimus and Keratosis--Actinic

Topics: Administration, Cutaneous; Aged, 80 and over; Aminolevulinic Acid; Clobetasol; Female; Humans; Keratosis, Actinic; Light; Ointments; Photochemotherapy; Photosensitizing Agents; Scalp Dermatoses; Tacrolimus; Treatment Outcome

Skin lesions are very common among organ transplant recipients (OTR), particularly infections and tumors, because of the immunosuppressive state these patients are put in.. 177 OTR were examined. Skin lesions were categorized into neoplastic, infectious, and inflammatory diseases.. The mean age of OTR was 52 years, the mean age at transplantation was 42.7 years, and kidney was the most common organ transplanted (72%). Skin lesions were found in 147 patients (83%). Cutaneous infections were seen in 106 patients (60%). Warts (30%) had the larger incidence and were associated with azathioprine (P = 0.026), cyclosporine (P = 0.006), and tacrolimus (P = 0.009). Superficial mycoses occurred in 16% of OTR, mostly onychomycosis, which was associated with tacrolimus (P = 0.040). Actinic keratosis (AK) occurred in 31% of patients and cutaneous tumors in 56%. Squamous cell carcinoma (SCC) was the most common tumor type affecting 36% of OTR (n = 64), with invasive SCC predominating over in situ SCC, whereas basal cell carcinoma (BCC) accounted for 17%. Both SCC and BCC were more numerous in patients' skin type I (P < 0.05). SCC was more frequent (36%) in combined kidney and liver recipients (P = 0.004), and BCC was associated with cyclosporine (P = 0.047). Inflammatory complications (acne, alopecia, hypertrichosis, and gingival overgrowth) were observed in 17.5% of patients.. Organ transplant recipients must be regularly evaluated by dermatologists, who should be alert to the onset of infections and skin (pre)malignant diseases in these patients.

Topics: Adolescent; Adult; Aged; Azathioprine; Brazil; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Child; Cyclosporine; Dermatomycoses; Female; Humans; Immunosuppression Therapy; Immunosuppressive Agents; Keratosis, Actinic; Male; Middle Aged; Organ Transplantation; Risk Factors; Skin Diseases, Infectious; Skin Neoplasms; Tacrolimus; Warts; Young Adult

Erosive pustular dermatosis of the scalp is a rare condition characterized by sterile pustules, erosions and crusted lesions on the scalp of elderly patients. It can be misdiagnosed with tinea capitis or even skin cancer, so it is important to be aware of this entity for a correct diagnosis. An 80-year-old Caucasian man presented with a 3 month history of painful erythematous erosions and crusts on his scalp. The lesions appeared after treatment with cryotherapy of actinic keratoses. The patient underwent treatment with topical mupirocine and topical antifungals without success. Physical examination revealed the presence of extensive erosions and crusts along the scalp, with tiny pustules on the sides. The clinical and histopathological findings lead us to the diagnosis of erosive pustular dermatosis of the scalp. Treatment with potent topical corticosteroids twice daily was started with improvement after ten days. A maintenance therapy with topical tacrolimus was initiated without clinical relapse after 3 months.

Topics: Administration, Topical; Adrenal Cortex Hormones; Aged, 80 and over; Biopsy; Cryotherapy; Humans; Immunosuppressive Agents; Keratosis, Actinic; Male; Scalp Dermatoses; Tacrolimus

Erosive pustular dermatosis of the scalp is a rare condition that tends to occur mainly in elderly patients. Clinically it is characterized by the presence of pustules, chronic crusted erosions with progressive scarring alopecia, and skin atrophy. Although etiology remains unclear, it seems to be triggered by local trauma such as surgical procedures, skin graft, ultraviolet light exposure, cryotherapy, craniotomy, or radiotherapy. To our knowledge, erosive pustular dermatosis of the scalp after photodynamic therapy has been seldom reported. We described a 81-year-old woman presenting with erosive pustular dermatosis of the scalp after photodynamic therapy for actinic keratosis.

Topics: Aged, 80 and over; Female; Humans; Keratosis, Actinic; Mometasone Furoate; Photochemotherapy; Pregnadienediols; Scalp Dermatoses; Skin Diseases, Vesiculobullous; Tacrolimus; Treatment Outcome