Pneumocystis carinii pneumonia in patients receiving immunosuppressive drugs for dermatological diseases

In recent years, Pneumocystis carinii pneumonia (PCP) has been increasingly reported in patients without human immunodeficiency virus (HIV) infection. The increased occurrence of PCP in non-HIV-immunocompromised subjects has been attributed to several factors: use of stronger immunosuppressive regim ens, higher awareness of PCP, advanced diagnostic technology and nosocomial spread of P. carinii. Appearance of PCP subsequent to the use of immunosup pressive drugs has been noticed in many inflammatory diseases such as rheum atoid arthritis, systemic lupus erythematosus and ulcerative colitis. Derma tologists frequently use immunomodulating agents, but the occurrence of PCP in patients receiving immunosuppressive drugs for skin diseases is largely unknown, We report four cases where PCP appeared following the use of immu nosuppressive drugs primarily for cutaneous diseases, namely pemphigus, cut aneous necrotizing vasculitis (two cases) and Behcet's syndrome, These case s were identified in a computerized database study (1979-95) to evaluate th e occurrence of PCP among immunocompromised hosts without HIV infection.