Dufrechou L, Larre Borges A, Nin M, Curi L, González F, Martínez M, Orihuela S
Department of Dermatology, Hospital de Clínicas, Montevideo, Uruguay.
Transplant Proc. 2011 Nov;43(9):3377-9. doi: 10.1016/j.transproceed.2011.09.088.
Uruguay is the second country of Latin America in prevalence of renal replacement therapies, including functioning kidney allografts. Long-term immunosuppressive therapy is essential for adequate graft function, but results in reduced immunosurveillance leading to an increased risk of complications such as infections and malignancies. A variety of cutaneous manifestations as well as an increase in non-melanoma skin cancers have been reported in this population. The objective of this study was to evaluate the frequency and clinical spectrum of cutaneous manifestations in renal and reno-pancreatic recipients in Uruguay. One hundred renal or reno-pancreatic recipients aged between 21- and 77-years-old were evaluated between September 2009 and September 2010. A total of 104 dermatoses were observed; 68% of the patients had at least one cutaneous manifestation. The most frequent dermatoses were cutaneous side effects due to immunosuppressive treatment (43.3%), followed by infections (27.9%), miscellaneous causes (22.1%), as well as malignant and premalignant lesions (6.7%). This is the first study evaluating dermatological complications in organ transplant recipients in our country. Most of the patients had at least one dermatological manifestation of immunosuppression, including a malignant or pre-malignant lesion, highlighting that this is a high-risk dermatological population. Cancer is one of the most important causes of death in recipients with functioning grafts. Its prevention is a major goal in the care of transplant recipients. Physicians in transplant units should be aware of the importance of dermatological screening and skin cancer surveillance.
乌拉圭是拉丁美洲肾替代疗法(包括正常工作的同种异体肾移植)患病率第二高的国家。长期免疫抑制治疗对于维持移植肾的正常功能至关重要,但会导致免疫监视功能下降,从而增加感染和恶性肿瘤等并发症的风险。据报道,该人群出现了多种皮肤表现以及非黑色素瘤皮肤癌的发病率增加。本研究的目的是评估乌拉圭肾移植和肾 - 胰联合移植受者皮肤表现的频率和临床谱。在2009年9月至2010年9月期间,对100名年龄在21岁至77岁之间的肾移植或肾 - 胰联合移植受者进行了评估。共观察到104种皮肤病;68%的患者至少有一种皮肤表现。最常见的皮肤病是免疫抑制治疗引起的皮肤副作用(43.3%),其次是感染(27.9%)、其他原因(22.1%)以及恶性和癌前病变(6.7%)。这是我国第一项评估器官移植受者皮肤并发症的研究。大多数患者至少有一种免疫抑制的皮肤表现,包括恶性或癌前病变,这突出表明这是一个高风险的皮肤病群体。癌症是移植肾功能正常的受者最重要的死亡原因之一。预防癌症是移植受者护理的主要目标。移植单位的医生应意识到皮肤筛查和皮肤癌监测的重要性。