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Background Patients unable to take azoles are a neglected group lacking a standardized approach to antifungal prophylaxis. We evaluated the effectiveness and safety of intermittent liposomal amphotericin B (L-AMB) prophylaxis in a heterogenous group of hematology patients. Methods A retrospective cohort of all hematology patients who received a course of intravenous L-AMB, defined as 1 mg/kg thrice weekly from July 1, 2013 to June 30, 2018, were identified from pharmacy records. Outcomes included breakthrough-invasive fungal disease (BIFD), reasons for premature discontinuation, and acute kidney injury. Results There were 198 patients who received 273 courses of L-AMB prophylaxis. Using a conservative definition, the BIFD rate was 9.6% (n = 19 of 198) occurring either during L-AMB prophylaxis or up to 7 days from cessation in patients who received a course. Probable/proven BIFD occurred in 13 patients (6.6%, 13 of 198), including molds in 54% (n = 7) and non- albicans Candidemia in 46% (n = 6). Cumulative incidence of BIFD was highest in patients with acute myeloid leukemia (6.8%) followed by acute lymphoblastic leukemia (2.7%) and allogeneic stem cell transplantation (2.5%). The most common indication for L-AMB was chemotherapy, or anticancer drug-azole interactions (75% of courses) dominated by vincristine, or acute myeloid leukemia clinical trials, followed by gut absorption concerns (13%) and liver function abnormalities (8.8%). Acute kidney injury, using a modified international definition, complicated 27% of courses but was not clinically significant, accounting for only 3.3% (9 of 273) of discontinuations. Conclusions Our findings demonstrate a high rate of BIFD among patients receiving L-AMB prophylaxis. Pragmatic trials will help researchers find the optimal regimen of L-AMB prophylaxis for the many clinical scenarios in which azoles are unsuitable, especially as targeted anticancer drugs increase in use. [ABSTRACT FROM AUTHOR]

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The article provides information on the case of a 32-month Pakistani girl diagnosed with Griscelli's syndrome characterized by partial albinism and immunodeficiency. The girl suffers from developmental delay, abdominal pain, and lethargy. She was also diagnosed with acute meningitis and hydrocephalus. The patient's histological examination shows that she has histiocytic tumour with a degree of erythrophagocytosis and lymphophagocytosis. Details about Griscelli's syndrome are also presented.

The article highlights a research on topical photodynamic therapy (PDT) used for treating inflammatory skin conditions such as morphoea. It defines morphoea as a connective-tissue disorder characterized by typical lesions which consist of sclerotic plaques affecting the skin and subcutaneous tissues. A detailed investigation to prove the curability of PDT on morphoea patients is presented.

A letter to the editor is presented discussing the efficacy and tolerability of ambient light in combination with 5-aminolaevulinic acid photodynamic therapy in treating patients with actinic keratoses.

A letter to the editor is presented concerning narrowband ultraviolet phototherapy as an effective treatment for psoriasis.

A letter to the editor is presented in response to the article "An audit of the management of cutaneous squamous cell carcinoma according to the multiprofessional guidelines."

Presents a letter to the editor about renal cell carcinoma.