Dufrechou L, Nin M, Curi L, Larre Borges P, Martínez Asuaga M, Noboa O, Orihuela S, González-Martínez F, Larre Borges A
Dermatology Department, Hospital de Clínicas "Dr. Manuel Quintela," Montevideo, Uruguay.
Nephrology Department, Hospital de Clínicas "Dr. Manuel Quintela," Montevideo, Uruguay; Instituto de Nefrología y Urología, Montevideo, Uruguay.
Transplant Proc. 2014 Nov;46(9):3047-9. doi: 10.1016/j.transproceed.2014.07.012.
Uruguay, with a total population of 3,345,000 inhabitants, is the Latin American country with the second highest number of renal replacement therapies. Long-term immunosuppressant therapy is essential for graft survival but results in reduced immunosurveillance, leading to an increased risk of complications. A variety of dermatological manifestations and a large increase in nonmelanoma skin cancers have been reported in this population. The purpose of this study was to evaluate the frequency and clinical spectrum of cutaneous manifestations in renal and renopancreatic recipients in 2 reference centers in Uruguay. Two hundred and six renal or renopancreatic recipients between 21 and 77 years old were evaluated between September 2009 and September 2011. A total of 206 dermatoses were observed; 60% of the patients had at least 1 cutaneous manifestation. The most frequent dermatoses were cutaneous side effects due to immunosuppressive treatment (40.6%), followed by infections (26.1%), miscellaneous causes (18.9%), and malignant and premalignant lesions (14.4%). Transplant recipients represent a high-risk dermatological population. Physicians in transplant units should be aware of the importance of dermatological screening in order to promote early detection of skin cancer.
乌拉圭总人口为334.5万,是拉丁美洲进行肾脏替代治疗人数第二多的国家。长期免疫抑制治疗对移植物存活至关重要,但会导致免疫监视功能下降,从而增加并发症风险。据报道,该国人群出现了多种皮肤表现,非黑色素瘤皮肤癌大幅增加。本研究的目的是评估乌拉圭两个参考中心肾移植和肾胰联合移植受者皮肤表现的发生率及临床谱。2009年9月至2011年9月期间,对206名年龄在21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206种皮肤病;60%的患者至少有1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(40.6%),其次是感染(26.1%)、其他原因(18.9%)以及恶性和癌前病变(14.4%)。移植受者是皮肤科的高危人群。移植科室的医生应意识到皮肤筛查的重要性,以便促进皮肤癌的早期发现。