Spectrum of Dermatological Lesions in Renal Allograft Recipients in a Tropical Environment

Abstract

A total of 157 renal allograft recipients were followed for over 1–23 months for the development of dermatological lesions. The non-infective lesions related to immunosuppressive drugs included cushingoid features in 133 (84.7%), xerosis in 120 (76.4%), striae in 69 (43.9%), hypertrichosis in 65 (21.6%), facial erythema in 42 (26.7%) and friable skin in 34 (21.4%) patients. Of the infective lesions, cutaneous mycoses were the most frequent (82.6%) and included tinea corporisand cruris in 82 (52.2%), tinea versicolor in 21 (13.3%), candidiasis in 7 (4%), onychomycosis in 4 (2%) and cryptococcosis in 2 (1.2%) patients. Viral infections included those due to herpes zoster in 17 (10.8%), herpes simplex in 5 (3.1%) and viral warts in 13 (8.2%) patients. Cutaneous malignancy was seen in 1 patient only.

Cutaneous manifestations in renal transplant recipients

“…Gluec et al from Turkey reported pityrasis versicolor in 36.3% patients as compared to 13.3% in some of the studies in India and 18% in West in renal transplant patients. [13][14][15] Dermatophytosis accounted for 42% of total infection in a study done by Selvi et al, which is similar to present study. 16 Deep fungal infections are very rare in these patients.…”

“…Among infections the incidence of verruca vulgaris was 9.3%, herpes zoster 6.25%, molluscum contagiosum 6.25%, varicella zoster 3.12%, herpes simplex 3.12% and cytomegalovirus infection 3.12%. 11,14,15 In present study warts and pityrasis versicolor were more common after one year of transplantation, but HSV infections and candidiasis were more common in the early period (less than 6 months) after transplantation which agrees with Benici et al 11 Warts were found to be numerous and of greater proportion in the late recipients, as they are more related to the duration of immunosuppression rather than the degree of immunosuppression. 17,18 One unique finding in present study was concomitant HSV and CMV infection which was not seen in previous studies.…”

“…Most common being acneiform eruption seen in 33.3% patients which is similar to other studies done by Chug et al, and Benici et al 11,14 Acneiform eruptions predominantly involved face, chest and back and were resistant to anti acne treatment. Hirsutism was seen in 15.6% patients.…”

Relapsing Tinea capitis by Microsporum canis in an Adult Female Renal Transplant Recipient

“…The prevalence of superficial fungal infection in RTP is greatly variable, ranging between 7 and 75% [1, 5, 6, 7, 8, 9]. …”

“…Onychomycosis and various forms of dermatophytosis were observed, respectively, in 2–43 and 2–52.2% of the RTP. Prevalence and severity were shown to increase with the duration of immunosuppression [5, 7, 9, 10]. Dermatophytoses (including tinea corporis, tinea cruris, and tinea pedis) in RTP often present atypical features: wide distribution [9, 10], a drug-eruption-like appearance [11], lack of inflammation and itching [9, 10]and a slow response to therapy [9, 10].…”