Skin Changes after Renal Transplantation: the First Results of Clinical Follow-up

Czech version

Authors: P. Cetkovská ¹; H. Szakos ¹; F. Šefrna ²; T. Reischig ²
Authors‘ workplace: Dermatovenerologická klinika FN a LFUK, Plzeň, přednosta prof. MUDr. Karel Pizinger, CSc. ¹; I. interní klinika FN a LFUK, Plzeň, přednosta prof. MUDr. Martin Matějovič, Ph. D. ²
Published in: Čes-slov Derm, 86, 2011, No. 1, p. 13-16
Category: Clinical and laboratory Research

Overview

The aim of our study
was to examine and follow patients after renal transplantation in the years from 2005 to 2010. These patients, due to the long-term immunosuppression, show an increased risk of skin tumors, especially, of non-melanoma skin cancer. In collaboration with transplant unit we repetitively examined 258 kidney transplant recipients including 165 males (64%) and 93 females (36%), of a mean age of 53 years, with an average time 8 years after transplantation and so the same time of immunosuppressive treatment. Most of them belonged to the phototype II and III. In spite of nephrologists and dermatologists recommendation only 33.3 % of patients used sunscreens and 20.5% clothes for photoprotection, but 45.7% of transplant recipients did not used any photoprotection. Skin tumors were diagnosed in 55 patients (21.3%): 27 squamous cell carcinomas in 23 patients (8.9%) including 13 patients with 14 carcinomas in situ (5.1%) and 60 basal cell carcinomas in 36 patients (14%). We treated actinic keratoses in 37 patients (14.3%). In 3 patients 4 malignant melanomas (1.2%) were found. We observed viral warts in 24.4% and atypical melanocytic nevi in 10.8% of cases. Statistically significant correlation of the skin cancer development and the patient’s age, the skin phototype and the length of immunosuppression was found. Only 9.3% of patients suffered from pruritus during hemodialysis treatment before transplantation. The results showed that kidney transplant recipients are at risk, especially, of non-melanoma skin cancer development and their sun photoprotection habits are insufficient. Therefore, regular dermatologic follow-up and proper education on the everyday photoprotection necessity are important.

Key words:
kidney transplantion – immunosuppressive therapy – hemodialysis – skin cancer – photoprotection

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Article was published in

Czech-Slovak Dermatology

2011 Issue 1