Cutaneous Manifestations in Renal Transplant Recipients

Background and Design: This study is designed to determine the prevalence and the clinical spectrum of skin diseases in renal transplant recipients (RTRs). Material and Method: In this study RTRs who were referred to our department between 2005 and 2007 for dermatologic examination were evaluated. Dermatologic investigation included direct clinical observation and culture or histolopathological investigation when indicated. Patients were divided into three groups: group A, post-transplantation periods :51 year; group B, post-transplantation periods of 1-5 years; and group C, post-transplantation periods >5 years. Results: In this study 88 (M=50, F=38) RTRs were evaluated. The mean age was 37 12 years and the median interval since transplantation was 38.5 months (range=1 month-27 years). Over a 2-year period 298 cutaneous manifestations were identified. Ninety-five immunosuppressive (IS) drug-related manifestations were observed in 58 (%65.9) patients and the most common one was acneiform eruption (n=23). Forty (45.5%) patients developed cutaneous viral infections, consisting of verruca vulgaris (n=29), herpes zoster (n=9), herpes simplex (n=5), molluscum (n=2) and varicella (n=1) infections. Superficial fungal infections were observed in 35(39.2%) patients, most common lesions were dermatophytosis (n = 23) and pityriasis versicolor (n=17). Bacterial infections were observed in 14 (%16) patients, folliculitis was present in 12 of them. Premalignant and malignant lesions were identified in 12 (%13.6) patients, consisting of actinic keratoses (n=9), basal cell carcinoma (n=2), squamous cell carcinoma (n=l) and Kaposi's sarcoma (n=l). There were more premalignant and malignant lesions in patients receiving azathioprine (p=0.002). Cutaneous viral infections were more common in group C (p=0.023) and IS drug-related manifestations were more common in group A (p=0.003). Conclusion: Most common cutaneous manifestation among RTRs was IS drug-related and seen in early post-transplantation period. Warts were the most common manifestation in late post-transplantation period. (Turkderm 2008; 42: 18-21)