O'Connell B M, Abel E A, Nickoloff B J, Bell B J, Hunt S A, Theodore J, Shumway N E, Jacobs P H
J Heart Transplant. 1986 Nov-Dec;5(6):430-6.
A total of 107 consecutive heart transplant recipients at Stanford University Medical Center were prospectively screened for dermatologic disease as part of their routine postoperative evaluation over a 6-month period. The incidence of nonmelanotic skin tumors and premalignant lesions was approximately 25-fold greater than expected in a normal population. Skin infections were seen in 55% of the patients and dermatologic drug side effects were almost universal including xerosis, hypertrichosis, and steroid acne. Successful excision or cryotherapy of all neoplastic lesions was achieved with no evidence of recurrence to date, a mean of 11 months. The skin infections responded to appropriate antiviral, antibacterial, and antifungal agents and the xerotic and acneiform lesions were successfully treated with emollients and topical retinoic acid, respectively. In addition, patients were instructed in preventive measures including the use of sunscreen agents and protective clothing. We conclude that heart transplant recipients have a significantly increased incidence of neoplastic, infectious, and drug-induced skin diseases. Routine dermatologic screening resulted in early identification and successful treatment of these lesions. We suggest that dermatologic screening is both feasible and valuable in this setting.
在6个月的时间里，斯坦福大学医学中心对107名连续的心脏移植受者进行了前瞻性皮肤病筛查，作为他们术后常规评估的一部分。非黑素性皮肤肿瘤和癌前病变的发生率比正常人群预期的高出约25倍。55%的患者出现皮肤感染，皮肤病药物副作用几乎普遍存在，包括皮肤干燥、多毛症和类固醇性痤疮。所有肿瘤性病变均成功切除或冷冻治疗，迄今为止，平均11个月无复发迹象。皮肤感染对抗病毒、抗菌和抗真菌药物有反应，皮肤干燥和痤疮样病变分别用润肤剂和外用维甲酸成功治疗。此外，还指导患者采取预防措施，包括使用防晒剂和防护服。我们得出结论，心脏移植受者患肿瘤性、感染性和药物性皮肤病的发生率显著增加。常规皮肤病筛查导致这些病变的早期识别和成功治疗。我们认为，在这种情况下，皮肤病筛查既可行又有价值。
