Prevalence of benign cutaneous disease among Oxford renal transplant recipients

Abstract

In this first comprehensive study on prevalence of benign cutaneous diseases in a UK transplant population, a wide range of skin disorders was identified. It is therefore important that RTRs have access to dermatology services post-transplantation for appropriate management of benign cutaneous conditions as well as early detection of cutaneous malignancy and education regarding risks of sun exposure.

Inflammatory Cutaneous Diseases in Renal Transplant Recipients

“…This finding is consistent with a previous study [6], but in apparent contrast with the fact that most patients of our series are receiving tacrolimus, commonly used to manage seborrhoeic dermatosis [28]. A possible explanation for this paradoxical behavior could be that only a percentage of seborrhoeic patients are full responders to tacrolimus [28], similarly to those affected by psoriasis [27].…”

“…Conversely, scant clinical data are available regarding the incidence of inflammatory skin diseases in patients with solid organ transplantation (Table 4). In a previous study performed to evaluate the incidence of cutaneous diseases in a group of 282 kidney transplant recipients, we reported that inflammatory conditions occur in 14.9% of patients [14], in agreement with previous studies [6,7]; an even lower occurrence of inflammatory diseases in transplanted patients was scored by [8], with only a few cases of acneiform eruptions, rosacea, asteatotic eczema, contact eczema and stasis dermatitis. Notably, the incidence of skin diseases with an immunologic pathogenesis is considered to be an even more uncommon event, with only a few sporadic cases reported [14,15].…”

“…Numerous studies have pointed out that skin infections and Non Melanoma Skin Cancers (NMSCs) are commonly occurring complications for transplant recipients [6,8,11,12,13,14] due to the long-term immunosuppression used to prevent transplant rejection. Conversely, scant clinical data are available regarding the incidence of inflammatory skin diseases in patients with solid organ transplantation (Table 4).…”

“…However, other cutaneous diseases may progressively develop, which afflict more than half of renal transplant recipients, including infections to different body districts and non-melanoma skin cancers; these side effects are iatrogenic and develop as a consequence of the long-term immunosuppressive treatment. Notably, inflammatory diseases of the skin are rarely reported [6], possible as a consequence of the direct therapeutic effect of immunosuppressive therapy on these diseases. In the most recent Oxford series of kidney transplant recipients [6], the prevalence of psoriasis and atopic dermatitis was very low, around 1.5%, as also reported in other case series [7,8].…”

“…Notably, inflammatory diseases of the skin are rarely reported [6], possible as a consequence of the direct therapeutic effect of immunosuppressive therapy on these diseases. In the most recent Oxford series of kidney transplant recipients [6], the prevalence of psoriasis and atopic dermatitis was very low, around 1.5%, as also reported in other case series [7,8]. This is not surprising, since cyclosporine is commonly used in the treatment of psoriasis and other inflammatory dermatoses [9], while tacrolimus and mycofenolate are currently proposed for the treatment of atopic dermatitis [10].…”