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肾移植受者的良性和恶性皮肤病变

Benign and malignant skin lesions in renal transplant recipients.

作者信息

Ghaninejad H, Ehsani A H, Ghiasi M, Noormohammadpour P, Najafi E, Naderi G, Ganji M, Mirnezami M, Nezami R, Kiani P

机构信息

Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Indian J Dermatol. 2009 Jul;54(3):247-50. doi: 10.4103/0019-5154.55634.

Abstract

BACKGROUND

Skin lesions - benign and malignant - occur frequently in organ transplant recipients receiving long-term immunosuppressive therapy. These patients are at greater risk of skin cancers.

AIMS

To study dermatologic problems in renal transplant recipients (RTRs).

METHODS

One hundred patients (53 men and 47 women) were consecutively examined for benign and malignant skin complications since transplantation in Razi Hospital in Tehran Medical University. The main immunosuppressive therapy regimen in these patients was a combination of prednisolone, azathioprine, and cyclosporine.

RESULTS

The early and most common complication was cosmetic side effects that occurred in 98% patients. Skin infections occurred in 83% of the patients and most of them were viral infections (65%), especially of human papilloma viruses (HPVs) in 40% of the patients. We found six cases of malignancy in these patients in that four cases were skin cancers, including one case of SCC, one BCC, and two cases of Kaposi's sarcoma. Dermatologic problems occur most frequently in RTRs, especially skin cancers which have higher frequency in these patients than general population, particularly, Kaposi sarcoma. Sun exposure has an important role in developing epithelial skin cancers following transplantation. The age of developing skin cancer in these patients was early than normal population.

CONCLUSION

Our results emphasize the importance of dermatologic examinations and monitoring RTRs to obtain an early diagnosis and treatment of cutaneous manifestations.

摘要

背景

良性和恶性皮肤病变在接受长期免疫抑制治疗的器官移植受者中频繁出现。这些患者患皮肤癌的风险更高。

目的

研究肾移植受者(RTRs)的皮肤问题。

方法

在德黑兰医科大学拉齐医院,对100例患者(53例男性和47例女性)自移植后连续检查良性和恶性皮肤并发症。这些患者的主要免疫抑制治疗方案是泼尼松龙、硫唑嘌呤和环孢素的联合使用。

结果

早期且最常见的并发症是美容副作用,98%的患者出现该情况。83%的患者发生皮肤感染,其中大多数是病毒感染(65%),尤其是人乳头瘤病毒(HPV)感染,40%的患者感染该病毒。我们在这些患者中发现6例恶性肿瘤,其中4例是皮肤癌,包括1例鳞状细胞癌、1例基底细胞癌和2例卡波西肉瘤。皮肤问题在肾移植受者中最常出现,尤其是皮肤癌,其在这些患者中的发生率高于普通人群,特别是卡波西肉瘤。移植后阳光照射在发生上皮性皮肤癌方面起重要作用。这些患者患皮肤癌的年龄比正常人群早。

结论

我们的结果强调了对肾移植受者进行皮肤科检查和监测以早期诊断和治疗皮肤表现的重要性。

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本文引用的文献

1
Cyclosporin-induced gingival overgrowth in children.环孢素引起的儿童牙龈增生
Int J Paediatr Dent. 2005 Nov;15(6):403-11. doi: 10.1111/j.1365-263X.2005.00676.x.
2
Cutaneous manifestations in Italian kidney transplant recipients.意大利肾移植受者的皮肤表现
Transplant Proc. 2005 Jul-Aug;37(6):2527-8. doi: 10.1016/j.transproceed.2005.06.067.
7
Renal transplantation, immunosuppression and the skin: an update.肾移植、免疫抑制与皮肤:最新进展
Photodermatol Photoimmunol Photomed. 2005 Feb;21(1):1-8. doi: 10.1111/j.1600-0781.2005.00128.x.
8
Clinicopathological aspects of 18 Kaposi's sarcoma among 1055 Greek renal transplant recipients.
Artif Organs. 2004 Jun;28(6):595-9. doi: 10.1111/j.1525-1594.2004.00019.x.
10
Skin cancers following pediatric organ transplantation.小儿器官移植后的皮肤癌
Dermatol Surg. 2004 Apr;30(4 Pt 2):616-21. doi: 10.1111/j.1524-4725.2004.30146.x.

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