ACCEPT:

• If donor occasionally uses steroid cream, tacrolimus (Protopic), or pimecrolimus (Elidel) or other creams over small areas (and none of the other deferral criteria apply)
• If the donor has a chronic superficial fungal infection and is only using local therapy e.g. ringworm, athlete’s foot, chronic fungal nail infection
• If the donor has been in contact with an individual with a chronic fungal condition
• If the donor has been in contact with an individual with scabies and is not infected
• If the donor had a basal cell carcinoma (rodent ulcer) and treatment is completed and all wounds are healed

 DEFER:

• For 2 weeks from date of recovery, if the donor has an infectious skin condition e.g. scabies or skin infection
• For 7 days from cessation of treatment for a nail fungal infection
• For 1 week from date of recovery from an open wound
• If venepuncture site is affected, until healed
• If the skin condition required the application of steroid cream, tacrolimus (Protopic) or pimecrolimus (Elidel) or other creams over large areas for periods of more than 3 weeks in the last 6 months
• For 36 months from the last dose of Neotigason
• For 4 weeks from the last dose of isotretinion (Roaccutane) or Alitretinion (Toctino)
• For 24 months after completing treatment other than (other than Etretinate (Tigason), if they have had Lichen Sclerosus, no history of associated malignancy and the symptoms are controlled with or withous intermittent topical steroid therapy

 PERMANENTLY EXCLUDE:

• If the donor has ever been treated with Tigason
• If the donor has a history of malignancy

ADDITIONAL INFORMATION

A donor who has been in contact with scabies but has no symptoms (e.g. itching) does not pose a risk to other donors or staff

Damaged skin can increase the risk of infection contaminating a donation. For this reason a venepuncture should not be performed through an area of affected skin

Many malignancies spread through the blood stream. It is therefore considered safer not to accept donations of blood from people who have been diagnosed with malignancy. Treated basal cell carcinoma is an exception to this as it is not spread through the blood stream

Initial treatment of Lichen Sclerosus is through specialist care with potent steroid therapies. This and other possible therapies used such as psoralenultraviolet A (PUVA) or methotrexate can cause immunosuppression. This may mask infective conditions which would prevent donation

Treatment can also be with retinoids such as Etretinate (Tigason®) or acitretin (Neotigason®). If taken systemically these can cause birth defects for babies exposed to them before birth. It is important to allow time for the drug to be cleared from the blood of a donor. Some drugs take longer to be cleared than others. Lichen Sclerosus itself is not an infection and is not contagious

Under normal circumstances the use of topical treatment with steroid, tacrolimus and pimecrolimus will not result in blood levels which cause suppression of the immune response. Immunosuppression is more likely if there is a skin barrier defect or high doses are used over large areas for extended periods. A large area of skin is defined as >9% (Wallace Rule of Nines). 1% is equal to the area of the closed digits and palm of the donor's hand

The cause of lichen planus is unknown but some cases have been associated with hepatitis C. It can take many months for the symptoms to resolve. Less than one in 50 adults is affected and it is slightly more common in women. It is not infectious or hereditary. Rarely can it become malignant