The spectrum of skin diseases in four different types of organ-transplant recipients: a comparative single-centre cohort study.

Abstract

Organ transplant recipients (OTR) are at marked increased risk of skin cancer and skin infections compared to the general population. The purpose of this study was to acquire long-term incidence data on commonly occurring skin diseases in four different transplant groups. This retrospective single-centre cohort study included 621 OTR. By counting defined malignant, inflammatory, infectious or drug-related skin conditions per patient and visit, incidence rates (IR) for the different groups of OTR were calculated as cases per 1000-patient years and cumulative incidences of non-melanoma skin cancer (NMSC), respectively. Overall, 2,309 non-malignant skin conditions and 340 NMSC were registered. Skin infections were most common (51.4%), followed by inflammatory skin conditions (35.6%) and sun-induced skin damage (32.9%). Kidney transplant recipients (KTR) had a 4.7-fold (95%CI: 2.7-8.0; p < 0.0001), 2.6-fold (95%CI: 1.2-5.3; p = 0.0098) and 5.4-fold (95%CI: 2.8-10.3; - < 0.0001) higher IR for oral candidiasis, oral aphthosis and herpes simplex virus infections, respectively, compared to the other OTR. Pruritus was most commonly reported in liver transplant recipients (95%CI: 1.3-5.3; p = 0.0047). KTR and lung transplant recipients (LuTR) had a 10.7-fold (95%CI:3.6-43.2; p < 0.0001) higher IR of steroid induced acne. KTR had a 1.6-fold (95%CI: 1.1-2.3; p = 0.0096) higher IR of squamous cell carcinoma compared to the other groups. The incidence of basal cell carcinoma was 2.5-fold higher (95%CI: 1.7-3.6; p < 0.0001) in LuTR, compared to the other OTR. This study provides additional organ-specific incidence data on non-malignant skin diseases and skin cancer in OTR.