Department of Dermatology, University of California Irvine, Irvine, USA.
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, USA.
Clin Exp Dermatol. 2020 Aug;45(6):722-726. doi: 10.1111/ced.14241. Epub 2020 Jun 15.
Symptomatic cutaneous metastases are associated with discharge, malodour, pruritus and pain, all of which may negatively impact quality of life and cutaneous health. We conducted a retrospective chart review of patients referred to the Dermatology Service at Memorial Sloan Kettering Cancer Center between August 2006 and June 2015, and characterized the microbial flora and antimicrobial management of cutaneous metastases in 64 patients. We detected pathogenic and/or opportunistic bacteria in 50% of skin lesions. The most commonly isolated organisms were Staphylococcus aureus and Pseudomonas aeruginosa. Patients treated with oral antibiotics, alone or in combination with topical agents, had a statistically significant better improvement in infectious symptoms than those treated without oral antibiotics. Our findings suggest that the normal skin microbial flora is disrupted in patients with symptomatic skin metastases. Oral antibiotics may provide benefit when used as first-line therapy for infected skin lesions in patients with symptomatic cutaneous metastases.
症状性皮肤转移与分泌物、异味、瘙痒和疼痛有关，所有这些都会对生活质量和皮肤健康产生负面影响。我们对 2006 年 8 月至 2015 年 6 月期间转诊至纪念斯隆凯特琳癌症中心皮肤科的患者进行了回顾性图表审查，并对 64 例皮肤转移患者的微生物菌群和抗菌药物管理进行了特征描述。我们在 50%的皮肤病变中检测到了致病性和/或机会性细菌。最常分离到的生物体是金黄色葡萄球菌和铜绿假单胞菌。单独使用口服抗生素或与局部药物联合使用的患者，其感染症状的改善程度明显优于未使用口服抗生素的患者。我们的研究结果表明，症状性皮肤转移患者的正常皮肤微生物菌群受到破坏。当作为有症状的皮肤转移患者感染性皮肤病变的一线治疗时，口服抗生素可能有益。
