Cutaneous manifestations of renal transplantation in a New Zealand population

Abstract

Aim: To document the skin manifestations of renal transplant recipients.

Methods: The findings in 52 patients (27 males; mean age 43.5 yr; range 22-74 yr; SD 12.0) with a stable renal transplant for a mean of 115.6 mth (range 3-258; SD 70.6). Thirty seven patients were on prednisone and azathioprine and 18 on prednisone, azathioprine and cyclosporin.

Results: Including prior observations, 48 cutaneous malignancies were identified in nine patients, with the ratio of squamous cell to basal cell carcinoma being 1.2:1. No metastases were detected. Actinic keratoses were present in 20 patients and tended to be multiple and present on sun exposed skin. A wide range of nonneoplastic lesions was documented, including warts in 75%. Human papillomavirus was isolated from 43% of warts.

Conclusions: Renal transplant recipients require regular skin examination. Patients with high recreational or work related sun exposure prior to, or after transplantation, and those who have had a previous skin malignancy, should be identified as high risk patients for skin cancer and have regular dermatological follow up.