Skin infections in Egyptian renal transplant recipients

Bakr, N.I.; Elsawy, Essam; Hamdy, Ahmed; Bakr, Mohamed A.

doi:10.1111/j.1399-3062.2010.00568.x

Cited by 14 publications

(13 citation statements)

References 18 publications

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“…The available literature indicates that the incidence of viral warts is varied from 11% to 53% of the population of patients after transplantation. 16,17 In our study, its appearance was observed in 38.5% of the patients, which is similar to the results obtained by Ramsay et al (42%). 17 We observed a correlation between the age of the patients after kidney transplantation, and the presence of viral warts on the feet (patients with warts were much older), and the same observation was made by Pruvost et al 18 The number of warts increases with the duration of immunosuppressive therapy, which is consistent with the observations of other authors.…”

Section: Methodssupporting

confidence: 82%

Cutaneous viral infections in patients after kidney transplantation: risk factors

Sułowicz¹,

Wojas‐Pelc²,

Kuźniewski³

et al. 2013

Polish Archives of Internal Medicine

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IntroductIon Infectious skin lesions are a common complication in renal transplant patients receiving immunosuppressive therapy.objEctIvEs The aim of this study was to assess the prevalence and factors contributing to the development of viral skin infections in kidney transplant patients. PAtIEnts And mEthodsThe study included 486 patients, 296 men (60.9%) and 190 women (39.1%), aged 46.1 ±13.1 years, 74.3 ±52.1 months post-transplantation, who remained mostly on triple immunosuppressive therapy. All skin lesions detected during the dermatological examination were described in detail, and the type, size, exact location, dependence on age, sex, and the used immunosuppressive therapy were established. Patients were followed for 5 years.rEsuLts Infectious skin lesions of viral origin were diagnosed in 189 of 486 patients (38.9%). The most frequent infections were viral warts (38.5%), which were more common in older patients (47.6 vs. 45.0 years, P <0.033). Viral warts were observed more often in men (P <0.031). Lesions of viral origin occurred more often in patients treated with immunosuppressive drugs for a longer period of time (53 vs. 37 months; P <0.021) and those who received azathioprine and cyclosporine A (P <0.001). In a multivariate logistic regression analysis, therapy with azathioprine was the only factor associated with increased risk of these complications (P <0.007).concLusIons Older age, male sex, and longer duration of immunosuppressive therapy affect the incidence of infectious skin lesions in patients after kidney transplantation. Treatment with cyclosporine A and azathioprine promotes the development of infectious viral warts. KEy wordscutaneous viral infections, immunosuppression, kidney transplantation, risk factors for infection orIGInAL ArtIcLE Cutaneous viral infections in patients after kidney transplantation: risk factors

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Section: Methodssupporting

confidence: 82%

Cutaneous viral infections in patients after kidney transplantation: risk factors

Sułowicz¹,

Wojas‐Pelc²,

Kuźniewski³

et al. 2013

Polish Archives of Internal Medicine

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“…In contrast, OM was more prevalent in those KTR without diabetes, suggesting that KTR per se was the predisposing condition: 25% of our non-diabetic KTR patients had OM. A single study addressed the role of diabetes in fungal skin infections in KTR, reporting increased prevalence in diabetic KTR [15] ; unfortunately, the analysis included OM and dermatophytosis altogether, the latter corresponding to most (72%) of the diagnoses. The reason for diabetes being a risk factor of OM in HD patients, but a "protective" factor in KTR is intriguing and warrants further investigation.…”

Section: Discussionmentioning

confidence: 99%

“…Several reasons may account for this variation, including different socio-demographic characteristics among the cohorts studied (e.g., gender and age), and different diagnostic criteria, often not clearly defined. In addition, only few studies compared the prevalence of OM with a control group, usually recruited among hospital staff [7,9,11,15] . Of note, there are no reports on the effectiveness of the current treatments for OM in these groups of patients.…”

mentioning

confidence: 99%

“…In this regard, there are some reports on OM frequency in patients undergoing hemodialysis (HD) treatment and kidney transplant recipients (KTR). However, these studies show a wide range of OM prevalence, in some cases not different from that of the respective control groups or from the prevalence expected for the general population [7][8][9][10][11][12][13][14][15] . Several reasons may account for this variation, including different socio-demographic characteristics among the cohorts studied (e.g., gender and age), and different diagnostic criteria, often not clearly defined.…”

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confidence: 99%

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Hemodialysis and Kidney Transplantation as Predisposing Conditions to Onychomycosis

Filho

Ventura²,

Criado

et al. 2017

Nephron

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Background/Aim: Onychomycosis (OM) is one of the commonest superficial fungal infections. Patients undergoing hemodialysis (HD) treatment and kidney transplant recipients (KTR) are considered at risk of contracting fungal infections, but the few published data do not reach the conclusion of whether they are predisposed to OM. This study aimed to determine the prevalence and etiology of OM in these patients and to determine the antifungal susceptibility profile of the isolated fungal species. Methods: We recruited 149 HD patients, 187 KTR, and a control group comprising 174 patients attending an internal medicine service with other diseases than renal diseases. All patients underwent an examination of all toenails to check for the presence of OM. Antifungal susceptibility tests were performed following the Clinical and Laboratory Standards Institute (CLSI) recommendations. Results: The prevalence rates of OM in HD patients (23.4%) and KTR (23.0%) were significantly higher than those in age- and sex-matched control groups (13.2%). In HD patients, OM was associated with diabetes but not with the duration of dialysis. In KTR, OM was more prevalent in those without diabetes and likely also in those using mycophenolate mofetil or azathioprine but was not associated with the duration of transplantation. Trichophyton rubrum was the most prevalent species (45.9%) followed by T. mentagrophytes (24.5%) and Candida parapsilosis (18.0%). Fluconazole, itraconazole, voriconazole, and terbinafine were all efficient against the isolates of dermatophyte, with terbinafine showing the lowest and fluconazole the highest minimal inhibitory concentrations. All isolates of C. parapsilosis were sensitive to the antifungals according to the CLSI criteria. Conclusion: We found a high prevalence of OM in HD and KTR patients and suggest that these conditions should be considered a risk factor of OM. All 4 antifungals evaluated in the study showed good in vitro activity against the etiologic agents.

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“…Onychomycosis is associated with patient dissatisfaction and decreased quality of life [8,9]. It is a common comorbidity of advanced age [10], diabetes [11,12], peripheral vascular disease [13], HIV [14], immunosuppression [15], obesity [16] and smoking [13]. …”

Section: Introductionmentioning

confidence: 99%

Do Genetic Mutations and Genotypes Contribute to Onychomycosis?

Gupta

Simpson²,

Brintnell³

2014

Dermatology

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Background: The variability in susceptibility to onychomycosis for individuals exposed to the same environmental risk factors raises the possibility that there may be individuals with a genetic predisposition to dermatophyte infection. Objective: To determine whether there are genetic mutations or genotypes which contribute to onychomycosis. Methods: The PubMed database was searched for examples of immune deficiencies resulting in dermatophyte infections. Results: There are mutations in the innate immune receptors Dectin-1 and its adaptor protein CARD9 which result in familial mucocutaneous infections. There are also specific human leukocyte antigen genotypes that are more common in individuals and families with a high prevalence of onychomycosis. In addition, some patients have been reported with insufficient levels of CD4+CD25+ regulatory T cells. These deficits impair a full innate and adaptive immune response and may result in chronic or recurrent infections. Conclusions: There are documented mutations and genotypes that contribute to familial and individual susceptibility to onychomycosis.

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Skin infections in Egyptian renal transplant recipients

Cited by 14 publications

References 18 publications

Cutaneous viral infections in patients after kidney transplantation: risk factors

Cutaneous viral infections in patients after kidney transplantation: risk factors

Hemodialysis and Kidney Transplantation as Predisposing Conditions to Onychomycosis

Do Genetic Mutations and Genotypes Contribute to Onychomycosis?

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