Piotr Nockowski, Iwona Chlebicka, Aleksandra Stefaniak, Magdalena Krajewska, Dorota Kaminska, Jacek C Szepietowski
{"title":"皮肤湿疹,仅限于移植的手。","authors":"Piotr Nockowski, Iwona Chlebicka, Aleksandra Stefaniak, Magdalena Krajewska, Dorota Kaminska, Jacek C Szepietowski","doi":"10.2147/CCID.S549774","DOIUrl":null,"url":null,"abstract":"<p><p>Hand transplantation is a vascularized type of composite tissue allotransplantation (CTA), involving the transfer of heterogeneous tissues such as skin, fat, bones, muscles, and nerves. Even with modern immunosuppression protocols, rejection remains a major obstacle in this field. We report the first documented case of eczema limited to the skin of a transplanted hand in a 38-year-old male born without a left hand. The patient underwent hand allotransplantation in December 2016 from a deceased donor with complete HLA mismatch and remained on stable triple immunosuppressive therapy. Six years post-transplantation, erythematous macules, papules, scaling, and increased keratosis appeared exclusively on the dorsal and palmar aspects of the grafted hand, involving approximately 80% of its skin surface, without lesions elsewhere. Histopathological examination confirmed subacute eczema, with no signs of acute or chronic rejection. Topical mometasone furoate ointment combined with an increased dose of oral prednisone (from 5 mg/day to 10 mg/day) resulted in marked improvement within two weeks, followed by complete resolution after several weeks of regular emollient use. No recurrence was observed during six months of follow-up. This case highlights the importance of differentiating between rejection and other dermatological conditions, such as eczema, in limb transplant recipients. Because eczema can closely mimic rejection, it may complicate post-transplant care and lead to unnecessary changes in immunosuppressive therapy if misdiagnosed. Accurate diagnosis is essential for appropriate management and graft survival.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"2457-2462"},"PeriodicalIF":2.2000,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479371/pdf/","citationCount":"0","resultStr":"{\"title\":\"Skin Eczema Limited to Transplanted Hand.\",\"authors\":\"Piotr Nockowski, Iwona Chlebicka, Aleksandra Stefaniak, Magdalena Krajewska, Dorota Kaminska, Jacek C Szepietowski\",\"doi\":\"10.2147/CCID.S549774\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Hand transplantation is a vascularized type of composite tissue allotransplantation (CTA), involving the transfer of heterogeneous tissues such as skin, fat, bones, muscles, and nerves. Even with modern immunosuppression protocols, rejection remains a major obstacle in this field. We report the first documented case of eczema limited to the skin of a transplanted hand in a 38-year-old male born without a left hand. The patient underwent hand allotransplantation in December 2016 from a deceased donor with complete HLA mismatch and remained on stable triple immunosuppressive therapy. Six years post-transplantation, erythematous macules, papules, scaling, and increased keratosis appeared exclusively on the dorsal and palmar aspects of the grafted hand, involving approximately 80% of its skin surface, without lesions elsewhere. Histopathological examination confirmed subacute eczema, with no signs of acute or chronic rejection. Topical mometasone furoate ointment combined with an increased dose of oral prednisone (from 5 mg/day to 10 mg/day) resulted in marked improvement within two weeks, followed by complete resolution after several weeks of regular emollient use. No recurrence was observed during six months of follow-up. This case highlights the importance of differentiating between rejection and other dermatological conditions, such as eczema, in limb transplant recipients. Because eczema can closely mimic rejection, it may complicate post-transplant care and lead to unnecessary changes in immunosuppressive therapy if misdiagnosed. Accurate diagnosis is essential for appropriate management and graft survival.</p>\",\"PeriodicalId\":10447,\"journal\":{\"name\":\"Clinical, Cosmetic and Investigational Dermatology\",\"volume\":\"18 \",\"pages\":\"2457-2462\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-09-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479371/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical, Cosmetic and Investigational Dermatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/CCID.S549774\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"DERMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical, Cosmetic and Investigational Dermatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/CCID.S549774","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"DERMATOLOGY","Score":null,"Total":0}
Hand transplantation is a vascularized type of composite tissue allotransplantation (CTA), involving the transfer of heterogeneous tissues such as skin, fat, bones, muscles, and nerves. Even with modern immunosuppression protocols, rejection remains a major obstacle in this field. We report the first documented case of eczema limited to the skin of a transplanted hand in a 38-year-old male born without a left hand. The patient underwent hand allotransplantation in December 2016 from a deceased donor with complete HLA mismatch and remained on stable triple immunosuppressive therapy. Six years post-transplantation, erythematous macules, papules, scaling, and increased keratosis appeared exclusively on the dorsal and palmar aspects of the grafted hand, involving approximately 80% of its skin surface, without lesions elsewhere. Histopathological examination confirmed subacute eczema, with no signs of acute or chronic rejection. Topical mometasone furoate ointment combined with an increased dose of oral prednisone (from 5 mg/day to 10 mg/day) resulted in marked improvement within two weeks, followed by complete resolution after several weeks of regular emollient use. No recurrence was observed during six months of follow-up. This case highlights the importance of differentiating between rejection and other dermatological conditions, such as eczema, in limb transplant recipients. Because eczema can closely mimic rejection, it may complicate post-transplant care and lead to unnecessary changes in immunosuppressive therapy if misdiagnosed. Accurate diagnosis is essential for appropriate management and graft survival.
期刊介绍:
Clinical, Cosmetic and Investigational Dermatology is an international, peer-reviewed, open access journal that focuses on the latest clinical and experimental research in all aspects of skin disease and cosmetic interventions. Normal and pathological processes in skin development and aging, their modification and treatment, as well as basic research into histology of dermal and dermal structures that provide clinical insights and potential treatment options are key topics for the journal.
Patient satisfaction, preference, quality of life, compliance, persistence and their role in developing new management options to optimize outcomes for target conditions constitute major areas of interest.
The journal is characterized by the rapid reporting of clinical studies, reviews and original research in skin research and skin care.
All areas of dermatology will be covered; contributions will be welcomed from all clinicians and basic science researchers globally.