DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20171508

Cutaneous manifestations in renal transplant recipients

Nekram Baghel, Sankalp Awasthi, Sweta S. Kumar

Abstract


Background: Skin lesions both benign and malignant occur frequently in renal transplant recipients receiving long term immunosuppressive drugs. Aim was to study cutaneous manifestations in renal transplant recipients (RTRs).

Methods: Thirty two patients with chronic kidney diseases who underwent renal transplant were included in the study. All of the patients were fully examined for cutaneous, hair, nail and mucosal changes. Diagnostic measures such as scraping and biopsy of the lesions was carried out, where necessary.

Results: Out of 32 patients, 23 (71.8%) were male and 9 (28.1%) were females. Skin infections occurred in 84.3% of the patients and most of them were fungal infections (37.5%), followed by viral infection in (31.2%) patients. Oral mucosal changes, hair and nail comprising of (34.3%), (71.8%), (43.7%) patients respectively. Only malignancy seen in one patient was basal cell carcinoma. Drug induced cutaneous manifestations were acneiform eruptions (18.75%), hirsutism (15.6%), hypertrichosis (9.3%), striae (6.25%), gingival hyperplasia (3.12%) and skin atrophy (3.12%).

Conclusions: Skin lesions are a significant problem in renal transplant recipients. A careful monitoring of these patients is recommended for early diagnosis and treatment.


Keywords


Gingival hyperplasia, Immune-suppressants, Renal transplant recipients

Full Text:

PDF

References


Sandhue K, Gupta S, Kumar B, Dhandha R, Udigiri, NK, Minz M. The pattern of mucocutaneous infections and infestations in renal transplant recipients. J Dermatol. 2003;30:590-5.

Güleç AT, Demirbilek M, Seçkin D, Can F, Saray Y, Sarifakioglu E, et al. Superficial fungal infections in 102 renal transplant recipients: A case control study. J Am Acad Dermatol. 2003;49:187-9.

Lugo-Janer G, Sanchez JL, Santiago-Depin E. Prevalence and clinical spectrum of skin diseases in kidney transplant recipients. J Am Acad Dermatol. 1991;24:410-5.

Euvard S, Kanitakis J, Claudy A. Skin cancers after organ transplantation. N Engl J Med. 2003;348:1681-5.

Bordea C, Wojnarowska F, Millard PR. Skin cancers in renal transplant recipients occur more frequently than previously recognized in a temperate climate. Arch Dermatol. 2004;77:574-9.

Barba A, Tessari G, Boschiero L, Chieregato GC. Renal transplantation and skin diseases. Nephron. 1996;73:131-3.

Carpenter CB. Improving the success of organ transplantation. N Engl J Med. 2000;342:647-8.

Cassettyl CT. Cytotoxic and antimetabolic agents. In: Fitzpatrick's dermatology in general medicine. 2nd ed. New York: McGraw-Hill; 2003:2398-2409.

Euvard S, Kanitakis J, Cochat P, Claudy A. Skin cancers following pediatric organ transplantation. Dermatol Surg. 2004;30:616-21.

Seukeran DC, Newstead CG, Cunliffe WJ. The compliance of transplant recipients with advice about sun protection measures. Br J Dermatol. 1998;138:301-3.

Bencini PL, Montagnino G, Sala F, De Vecchi A, Crosti C, Tarantigo A. Cutaneous lesion in 67 cyclosporine treated renal transplant recipients. J Am Acad Dermatol. 1986;172:24-30.

Rafi A, Ghacha R, Singha A, Issam A, Mohammad I. Spectrum of skin diseases in renal transplant recipients. Dial transplant. 2000;30:282-5.

Demirbilek M, Seçkin D, Can F, Saray Y, Sarifakioglu E, et al. Superficial fungal infections in 102 renal transplant recipients: A case control study. J Am Acad Dermatol. 2003;49:187-9.

Chugh KS, Sharma SC, Singh V, Sakhuja V, Jha V, Gupta KL. Spectrum of dermatological lesions in renal allograft recipients in a tropical environment. Arch Dermatol. 1994;188:108-12.

Koranda FC, Dehmel EM, Kahn G, Penn I. Cutaneous complications in immunosuppressed renal homograft recipients. JAMA. 1974;229:419-24.

Selvi GS, Kamalam A, Ajithdos K, Janaki C, Thambiah AS. Clinical and mycological features of dermatophytosis in renal transplant recipients. J ClinPathol. 1999;42:75-8.

Dyall SD, Trowell H, Dyall SML. Benign human papilloma virus infection in renal transplant recipients. Int J Dermatol. 1991;30:785-9.

Rudlinger R, Smith IW, Bunney MH, Hunter JA. Human papilloma virus infections in a group of renal transplant recipients. Br J Dermatol. 1986;115:681-92.

Barba A, Tessari G, Boschiero L, Chieregato GC. Renal transplantation and skin diseases. Nephron. 1996;73:131-3.

Moosa MR. Racial and ethnic variations in incidence and pattern of malignancies after kidney transplantation. Medicine. 2005;84:12-22.

Formicone F, Fargnoli MC, Pisani F, Rascente M, Famulari A, Peris K. Cutaneous manifestations in Italian kidney transplant recipients. Transplant Proc. 2005;37:2527-8.

Jensen P, Hansen S, Moller B, Leivestad T, Pfeffer P, Geiran O, et al. Skin cancer in kidney and heart transplant recipients and different long-term immunosuppressive therapy regimens. J Am Acad Dermatol. 2000;42:307.

Hepburn DJ, Divakar D, Bailey RR, Macdonald KJ. Cutaneous manifestations of renal transplantation in a New Zealand population. N Z Med J. 1994;107:497-9.

Ramsay HM, Fryer AA, Hawley CM, Smith AG, Harden PN. Non-melanoma skin cancer risk in the Queensland renal transplant population. Br J Dermatol. 2002;147:950-6.

Tawade YV, Gokhale BB. Dermatogical manifestations of chronic renal failure. Indian J Dermatol Venerol Leprol. 1996;62:155-6.