Skin disorders in renal transplant recipients: a retrospective study

Abstract

BackgroundImmunosuppressive therapy, which is necessary to avoid graft rejection in renal transplant recipients, presents an increased risk of several pathologies, namely infectious and neoplastic.ObjectivesTo identify the most frequent skin diseases and their clinical and demographical risk factors within a population of renal transplant recipients.MethodsA retrospective study of renal transplant recipients referred to dermatology visit and observed for the first time from January 2008 to December 2014.ResultsThe study included 197 patients, 120 men (60,9%). Mean age was 50,7 years (±13,4). 12 patients (6,1%) had previous skin cancer. Infections were the most frequent reason of referral (93/197; 44%). From the total referred, 18,3% (36/197) presented pre-cancerous lesions. Malignancy was diagnosed in 36 patients (18,3%), with 29 non-melanoma skin cancers (14,7%) and 7 Kaposi sarcomas (3,6%). Ratio of basal cell carcinoma to squamous cell carcinoma was 1,1:1. Non-melanoma skin cancer was significantly associated with older age (p = 0,002), male gender (p = 0,028), history of previous skin cancer (p = 0,002) and higher duration of immunosuppressive therapy (p<0,001).Study limitationsRetrospective study, with data from the first visit in dermatology. We didn't made classification on skin-types.ConclusionsThe great incidence of cutaneous infections and skin cancer is responsible for a significant morbidity. It is important to assure the regular dermatological follow-up of renal transplant recipients, which will promote the prevention, an early diagnosis and an efficient treatment.

Perioral dermatitis: Diagnosis, proposed etiologies, and management

“…[15][16][17][18] Corticosteroid use following renal transplant was found to trigger POD in patients in one study. 19 In a separate report, a 37-year-old woman with myasthenia gravis treated with oral prednisone at a dose of 100 mg daily in addition to pyridostigmine was diagnosed with POD after three weeks of treatment. 20 Young and colleagues presented two patients who developed childhood granulomatous periorificial dermatitis following growth hormone therapy for short stature which resolved upon discontinuation.…”

“…Four case reports investigated the association of oral corticosteroids and POD 15‐18 . Corticosteroid use following renal transplant was found to trigger POD in patients in one study 19 . In a separate report, a 37‐year‐old woman with myasthenia gravis treated with oral prednisone at a dose of 100 mg daily in addition to pyridostigmine was diagnosed with POD after three weeks of treatment 20 .…”

Cutaneous Squamous Cell Carcinoma in Solid Organ Transplant Patients

“…In the last 10 years, four reviews about cutaneous malignancies in SOTR were published. [15][16][17][18] Data about these studies is summarized in Table 1. In these publications, the number of transplant recipients ranged from 127-319 patients, with a mean age of 50.7-63.5 years and a predominance of male patients (60.9%-88.9%).…”

Routine outpatient dermatological evaluation of kidney transplant recipients using dermatoscopy as an additional tool: a preliminary analysis

“…Notably, transplant patients have a higher mortality rate from skin cancer compared to breast or colon cancer in the general population [6,7]. The incidence of SCC is significantly higher in RTx, with a 65-to 250-fold increase, while BCC has a 10-to 16fold increase [8,6]. SCC is associated with considerable morbidity and mortality, with reported metastatic rates of up to 8% (versus 1% in the general population) and a 3-year mortality rate of 46% for metastatic disease [5,6].…”