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WS109 The skin in organ transplant recipients
Workshops - Pigmentaty Disorders - Update in Management
Diseasesof the Immunosuppressed Host WSI 06 lmmunosuppression and the skin. Lesions and concepts from congenital immunodeficiencies J.-H. Saurat. Clinic of Dermatology, University Hospital, Geneva, Switzerland Abstract not available.
WSI 07 Aids & the skin - What’s on R.C.D. Staughton. England The major change that has occurred on the HIV scene in the past year has been the introduction of highly active anti-retroviral therapies (HAART). These regimes, if tolerated and complied with, suppress viral replication and reverse immunosuppression. The effect of this on infirmatory neoplastic and viral conditions has been dramatic and the death rate has been reduced by some 30% in our Unit. The impact of these changes on the skin manifestations of HIV will be discussed.
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an extensive course and require parenteral acyclovir treatment. Human papillomavirus infections involve more than 80% of patients after 5 years and may progress towards malignancy. Fungal infections concern 20% of patients. Kaposi’sarcoma is .500-fold more frequent in transplant patients than in control groups and occurs in certain ethnic groups. A new herpes-like virus (HHVS) could be involved. Many cases may be improved by the decrease of the immunosuppressive treatment. Skin carcinomas, especially squamous-cell carcinomas are the most frequent malignancies and their incidence increases with time after transplantation (4@-70% after 20 years). They concern fair-skinned patients on sun-exposed areas and may have an aggressive course. They tend to be multiple and are associated to premalignant keratoses, keratoacanthomas and Bowen’s disease. Most lesions are successfully treated by surgical excision but topical or systemic retinoids may be useful. Prevention must be performed by sun protection.
Pigmentary Disorders - Update in Management WS.110 New pigmentary disorders
WS108 Skin cancer in PUVA patients J.M. McGregor. Dept of Photobiology, St Johns’ Institute of Dermatology and Imperial Cancer Skin Tumour Laboratory, Royal London Hospital, London, UK Psoralen photochemotherapy (PUVA) is widely used in the treatment of inflammatory and malignant dermatoses, including psoriasis, eczema and mycosis fungoides. Accumulating data suggest that PUVA treatment is associated with an increased risk of non-melanoma skin cancer (NMSC), particularly squamous cell cancer. Risk factors include age, cumulative UVA dose and skin types I-III. Patients with mycosis fungoides may be more at risk of NMSC than those with psoriasis. It is not yet known whether the mutagenic or immunosuppressive effect of PUVA predominates in the development of skin cancer. Prior sun exposure does not seem to be an important factor since many tumours develop on non sun-exposed sites. Human papillomavirus DNA sequences, found in tumours of immunosuppressed renal transplant patients, have so recently been found in NMSC from PUVA patients.
WSI 09 The skin in organ transplant recipients S. Euvrard. Clinique Dermatologique, Lyon, France
Hopital Ed. Herriot,
Dermatologists are often faced with the management of organ transplant recipients. These patients are more and more numerous thanks to the development of transplantation surgery and to improvements in immunosuppressive therapy. They present multiple skin complications including iatrogenic pathology and immunosuppression-related undesired effects. Iatrogenic pathology comprises mainly steroid acne and cyclosporine hypertrichosis. Immunodeficiency is responsible for viral infections and malignancy. Herpes (simplex and zoster) may have
J.-P. Ortonne. U385 INSERM, Fact&e’ de Medecine, Service de Dermatologie, Hopital de I’Archet, Nice, France Changes in hair and skin color occur as isolated findings or as ectodermal symptoms of complex disorders. During the recent past, several pigmentaty abnormalities that had not been previously described, have been reported. They include congenital and hereditary disorders such as temperature sensitive oculocutaneous albinism, oculocutaneous albinism type 3, the white lentiginosis, lentiginosis and arterial dissection, pigmentary abnormalities of cutaneous mosaicism, diffuse heterochromia of scalp hair and acquired abnormalities such as radiation lentigo and ink spot lentigo. The molecular dissection of pigmentary genodermatoses has also led to the discovery of new genes involved in the control of melanocyte embryogenesis, proliferation and differentiation. These different disorders will be illustrated and discussed.
( WS111 1 New techniques for the clinical evaluation of pigmentary disorders J.M. Naeyaert ’ , Y. Vander Haeghen ‘,‘. ‘Department of Dermatology, University Hospital; 2Faculty qf Engineering, ELLS-MEDISIP University of Gent, Belgium An overview of available techniques useful in evaluating patients with a pigmentary disorder will be given. The diagnostic performance of dermoscopy in evaluating pigmented skin lesions will be briefly reviewed. Present and future applications of digital imaging will be presented. Other techniques of potential interest to clinicians include: reflectance spectroscopy, ultrasonography, magnetic resonance imaging and calorimetry.
Diseasesof the Immunosuppressed Host WSI 06 lmmunosuppression and the skin. Lesions and concepts from congenital immunodeficiencies J.-H. Saurat. Clinic of Dermatology, University Hospital, Geneva, Switzerland Abstract not available.
WSI 07 Aids & the skin - What’s on R.C.D. Staughton. England The major change that has occurred on the HIV scene in the past year has been the introduction of highly active anti-retroviral therapies (HAART). These regimes, if tolerated and complied with, suppress viral replication and reverse immunosuppression. The effect of this on infirmatory neoplastic and viral conditions has been dramatic and the death rate has been reduced by some 30% in our Unit. The impact of these changes on the skin manifestations of HIV will be discussed.
SlOl
an extensive course and require parenteral acyclovir treatment. Human papillomavirus infections involve more than 80% of patients after 5 years and may progress towards malignancy. Fungal infections concern 20% of patients. Kaposi’sarcoma is .500-fold more frequent in transplant patients than in control groups and occurs in certain ethnic groups. A new herpes-like virus (HHVS) could be involved. Many cases may be improved by the decrease of the immunosuppressive treatment. Skin carcinomas, especially squamous-cell carcinomas are the most frequent malignancies and their incidence increases with time after transplantation (4@-70% after 20 years). They concern fair-skinned patients on sun-exposed areas and may have an aggressive course. They tend to be multiple and are associated to premalignant keratoses, keratoacanthomas and Bowen’s disease. Most lesions are successfully treated by surgical excision but topical or systemic retinoids may be useful. Prevention must be performed by sun protection.
Pigmentary Disorders - Update in Management WS.110 New pigmentary disorders
WS108 Skin cancer in PUVA patients J.M. McGregor. Dept of Photobiology, St Johns’ Institute of Dermatology and Imperial Cancer Skin Tumour Laboratory, Royal London Hospital, London, UK Psoralen photochemotherapy (PUVA) is widely used in the treatment of inflammatory and malignant dermatoses, including psoriasis, eczema and mycosis fungoides. Accumulating data suggest that PUVA treatment is associated with an increased risk of non-melanoma skin cancer (NMSC), particularly squamous cell cancer. Risk factors include age, cumulative UVA dose and skin types I-III. Patients with mycosis fungoides may be more at risk of NMSC than those with psoriasis. It is not yet known whether the mutagenic or immunosuppressive effect of PUVA predominates in the development of skin cancer. Prior sun exposure does not seem to be an important factor since many tumours develop on non sun-exposed sites. Human papillomavirus DNA sequences, found in tumours of immunosuppressed renal transplant patients, have so recently been found in NMSC from PUVA patients.
WSI 09 The skin in organ transplant recipients S. Euvrard. Clinique Dermatologique, Lyon, France
Hopital Ed. Herriot,
Dermatologists are often faced with the management of organ transplant recipients. These patients are more and more numerous thanks to the development of transplantation surgery and to improvements in immunosuppressive therapy. They present multiple skin complications including iatrogenic pathology and immunosuppression-related undesired effects. Iatrogenic pathology comprises mainly steroid acne and cyclosporine hypertrichosis. Immunodeficiency is responsible for viral infections and malignancy. Herpes (simplex and zoster) may have
J.-P. Ortonne. U385 INSERM, Fact&e’ de Medecine, Service de Dermatologie, Hopital de I’Archet, Nice, France Changes in hair and skin color occur as isolated findings or as ectodermal symptoms of complex disorders. During the recent past, several pigmentaty abnormalities that had not been previously described, have been reported. They include congenital and hereditary disorders such as temperature sensitive oculocutaneous albinism, oculocutaneous albinism type 3, the white lentiginosis, lentiginosis and arterial dissection, pigmentary abnormalities of cutaneous mosaicism, diffuse heterochromia of scalp hair and acquired abnormalities such as radiation lentigo and ink spot lentigo. The molecular dissection of pigmentary genodermatoses has also led to the discovery of new genes involved in the control of melanocyte embryogenesis, proliferation and differentiation. These different disorders will be illustrated and discussed.
( WS111 1 New techniques for the clinical evaluation of pigmentary disorders J.M. Naeyaert ’ , Y. Vander Haeghen ‘,‘. ‘Department of Dermatology, University Hospital; 2Faculty qf Engineering, ELLS-MEDISIP University of Gent, Belgium An overview of available techniques useful in evaluating patients with a pigmentary disorder will be given. The diagnostic performance of dermoscopy in evaluating pigmented skin lesions will be briefly reviewed. Present and future applications of digital imaging will be presented. Other techniques of potential interest to clinicians include: reflectance spectroscopy, ultrasonography, magnetic resonance imaging and calorimetry.