Department of Dermatology, University of São Paulo Medical School, Av Dr Enéas de Carvalho Aguiar, 255, 05403-900 São Paulo, SP, Brazil.
Department of Dermatology, University of Texas Health Science Center, 6410 Fannin Street, Houston, TX 77030, United States.
Transpl Immunol. 2021 Feb;64:101355. doi: 10.1016/j.trim.2020.101355. Epub 2020 Nov 29.
Solid organ transplant recipients (SOTRs) are susceptible to various cutaneous side effects as a consequence of long-term immunosuppressive therapy. Skin cancers and infections are well-studied complications that can cause death and/or allograft rejection. Other cutaneous drug reactions, such as inflammatory manifestations, have a high prevalence but are rarely studied. We analyzed these manifestations' prevalence and their association with immunosuppressants in transplant recipients from a Brazilian tertiary center. Among 532 SOTRs followed at our dermatology clinic, 60 (11.3%) developed some cutaneous adverse reactions to the immunosuppressants, with a median age at transplantation of 50.5 years and a median life span posttransplantation of seven years. Acneiform eruption was the most common drug reaction found (21 patients, 30.4%), followed by diffuse non-scarring alopecia (16 patients, 23.1%), lymphedema (10 patients, 14.5%), gingival hyperplasia (7 patients, 10.1%), hypertrichosis (6 patients, 8.7%) and sebaceous hyperplasia (9 patients, 13.1%). Adequate immunosuppression is an essential prerequisite for successful organ transplantation. In the immediate post-transplant period, significant immunosuppression is needed, but after that, the complications of excessive immunosuppression outweigh the risk of organ rejection. SORTs may present with a broad spectrum of inflammatory and cosmetic findings due to immunosuppressants that can impair life quality.
实体器官移植受者（SOTR）由于长期免疫抑制治疗而易患各种皮肤副作用。皮肤癌和感染是研究充分的并发症，可导致死亡和/或移植物排斥。其他皮肤药物反应，如炎症表现，具有较高的患病率，但很少研究。我们分析了巴西一家三级中心移植受者中这些表现的患病率及其与免疫抑制剂的关系。在我们皮肤科诊所随访的 532 名 SOTR 中，有 60 名（11.3%）发生了与免疫抑制剂有关的某种皮肤不良反应，移植时的中位年龄为 50.5 岁，移植后中位生存时间为 7 年。痤疮样疹是最常见的药物反应（21 例，30.4%），其次是弥漫性非瘢痕性脱发（16 例，23.1%）、淋巴水肿（10 例，14.5%）、牙龈增生（7 例，10.1%）、多毛症（6 例，8.7%）和皮脂增生（9 例，13.1%）。适当的免疫抑制是成功器官移植的必要前提。在移植后立即，需要进行大量免疫抑制，但此后，过度免疫抑制的并发症超过了器官排斥的风险。SORT 可能由于免疫抑制剂而表现出广泛的炎症和美容表现，这可能会损害生活质量。
