Abstract
Kidney transplant recipients frequently suffer from skin infections and malignancies, possibly due to the effects of long-term immunosuppressive therapy. While the relationships between immunosuppression and these pathological conditions have been widely investigated, little is known about the relative incidence and characteristics of inflammatory skin diseases in this type of patient. In this study, we analyze the incidence of a number of inflammatory cutaneous diseases in a cohort of patients who underwent kidney transplantation. Although our study shows a relatively low incidence of these pathologies in transplanted patients—in agreement with the general action of immunosuppressant therapies in reducing inflammation—we scored a different efficacy of the various immunosuppressive regimens on inflammatory and autoimmune skin diseases. This information can be key for designing immunosuppressive regimens and devising accurate follow-up protocols.
Highlights
Patients with chronic renal insufficiency often suffer from pathological conditions such as skin dryness, alopecia, skin discoloration, hair and nail abnormalities, as well as cutaneous diseases related to kidney failure [1,2,3,4]
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 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]
A diagnosis of skin cancer during follow-up was made in 191 cases (31.3%); according to the histological type, we scored basal cell carcinomas (BCCs) in 84 patients, squamous cell carcinomas (SCCs) in 51, melanomas in 16, Kaposi’s Sarcoma in 17, cutaneous T-cell lymphomas (CTCLs) in four and other skin tumors in nine
Summary
Patients with chronic renal insufficiency often suffer from pathological conditions such as skin dryness, alopecia, skin discoloration, hair and nail abnormalities, as well as cutaneous diseases related to kidney failure [1,2,3,4]. 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 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]. We describe the experience of our Clinical Units regarding the incidence and characteristics of various inflammatory skin diseases in a cohort of kidney transplant recipients, followed-up from 2009 to 2016
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