Division of Clinics and Oncological Dermatology, University of Turin, via Cherasco 23, Turin, Italy.
Eur J Dermatol. 2011 Mar-Apr;21(2):242-7. doi: 10.1684/ejd.2011.1272.
Kidney transplant recipients frequently suffer from skin infections and malignancies, due to the effects of long-term immunosuppressive therapy. Herein, a dermatological screening was performed to evaluate the relationship between risk factors, cutaneous tumours and other skin diseases in a group of 282 kidney transplant patients. Infectious diseases (16.7%) were the most frequent dermatological disorders, whereas cutaneous inflammatory and autoimmune diseases were relatively rare, probably due to an indirect therapeutic role of immunosuppressive regimens. Thirty patients experienced cutaneous side effects from immunosuppressants, mainly when receiving corticosteroids (p = 0.0372). We identified 99 patients (35.1%) who developed cutaneous tumours after transplantation. Cumulative tumour incidence was observed during long-term immunosuppressive therapy; no relationships were identified between skin cancer risk and single class of drug or combination regimens. When we evaluated the eventual relevance of other risk factors for skin cancers, we demonstrated a statistical significance in univariate analysis for male gender, more advanced age at transplantation, long duration of immunosuppressive regimens, no sunscreen usage, outdoor job, absence of cherry angiomas and presence of actinic keratoses (AKs). Age at transplantation (p = 0.0174), presence of AKs (p = 0.0005) and duration of immunosuppression (p = 0.0011) also confirmed their significance in multivariate analysis.
肾移植受者由于长期免疫抑制治疗的影响,常患有皮肤感染和恶性肿瘤。在此,对 282 例肾移植患者进行了皮肤科筛查,以评估危险因素、皮肤肿瘤和其他皮肤病之间的关系。传染病(16.7%)是最常见的皮肤科疾病,而皮肤炎症和自身免疫性疾病相对较少,这可能是由于免疫抑制方案的间接治疗作用。30 名患者出现免疫抑制剂相关的皮肤副作用,主要发生在使用皮质类固醇时(p=0.0372)。我们发现 99 名患者(35.1%)在移植后出现皮肤肿瘤。累积肿瘤发生率在长期免疫抑制治疗期间观察到;未发现皮肤癌风险与单一药物类别或联合方案之间存在关系。当我们评估其他皮肤癌风险因素的最终相关性时,我们在单变量分析中证明了男性、移植时年龄较大、免疫抑制方案持续时间较长、不使用防晒霜、户外工作、无樱桃状血管瘤和存在光化性角化病(AK)等因素具有统计学意义。移植时的年龄(p=0.0174)、存在 AK(p=0.0005)和免疫抑制持续时间(p=0.0011)在多变量分析中也证实了它们的意义。