Schmook T, Nindl I, Ulrich C, Meyer T, Sterry W, Stockfleth E
Department of Dermatology, University Hospital Charité, Schumannstrasse 20-21, D-10117 Berlin, Germany.
Br J Dermatol. 2003 Nov;149 Suppl 66:20-4. doi: 10.1046/j.0366-077x.2003.05627.x.
The long-term success of organ transplantation depends on the prevention of allograft rejection and improvement in quality of life for the patients. This has been achieved through better immunosuppressive regimens with lower dosages and a new generation of immunosuppressive drugs. However, these immunosuppressive agents not only impair the patient's reactivity to the graft, but also to infectious organisms, thereby making them more susceptible to opportunistic pathogens. Because of this, organ transplant recipients are predisposed to epithelial malignancies and infections. The majority of transplant recipients will develop warts induced by human papillomavirus (HPV). Some of these viral warts may present with atypical histological features and may progress into squamous cell carcinomas. The risk for cutaneous cancers after transplantation is much higher than in the immunocompetent population. Current therapies for HPV-associated skin tumours mainly depend on the destruction of affected skin areas. These treatment modalities are of limited efficacy and are usually painful for the patients. A promising novel therapeutic agent is imiquimod, an immune response modifier. Clinical efficacy of imiquimod has been observed for different skin lesions, including viral warts in both immunocompetent and immunosuppressed patients.
器官移植的长期成功取决于预防同种异体移植排斥反应以及提高患者的生活质量。这已通过使用更低剂量的更好的免疫抑制方案和新一代免疫抑制药物得以实现。然而，这些免疫抑制剂不仅会损害患者对移植物的反应性，还会影响其对感染性生物体的反应，从而使他们更容易受到机会性病原体的侵袭。因此，器官移植受者易患上皮性恶性肿瘤和感染。大多数移植受者会出现由人乳头瘤病毒（HPV）引起的疣。其中一些病毒性疣可能具有非典型的组织学特征，并可能进展为鳞状细胞癌。移植后皮肤癌的风险远高于免疫功能正常的人群。目前针对HPV相关皮肤肿瘤的治疗主要依赖于对受影响皮肤区域的破坏。这些治疗方式疗效有限，而且通常会给患者带来痛苦。一种有前景的新型治疗药物是咪喹莫特，一种免疫反应调节剂。在免疫功能正常和免疫抑制的患者中，均已观察到咪喹莫特对包括病毒性疣在内的不同皮肤病变具有临床疗效。
