Ali Fatima, Cronin Antonia
Department of Nephrology and Transplantation, Guy's and St Thomas' Hospitals NHS Trust, London, UK.
King's College London, London, UK.
Skin Health Dis. 2025 May 12;5(4):256-262. doi: 10.1093/skinhd/vzaf016. eCollection 2025 Aug.
Immunosuppression medication is an important risk factor for skin cancer in kidney transplant recipients (KTR). Both HIV-associated immunodeficiency and immunosuppression required for kidney transplantation increase skin cancer rates. Kidney transplant recipients living with HIV (KTRLHIV) must take steps to minimize their risk of skin cancer through prevention.
To conduct a cross-sectional study to investigate photoprotection knowledge and practices, and skin cancer awareness in KTRLHIV compared with a matched cohort of HIV-negative KTR.
Our study, conducted at a tertiary UK HIV kidney transplantation centre, utilized a validated sun photoprotection and skin cancer awareness questionnaire either online or in person. The KTRLHIV cohort ( = 27) and HIV-negative KTR cohort ( = 25) were matched for age, sex, ethnicity and years since transplant.
Only 60% of KTRLHIV had been seen by a dermatologist, compared with 81% in the matched KTR cohort. Sun protection advice was received by 52% of KTRLHIV, significantly lower than the 80% in the matched cohort ( = 0.03), primarily sourced from nephrologists or dermatologists. KTRLHIV exhibited lower overall sunscreen use (33% vs. 60%, = 0.05), fewer daily users (22% vs. 27%), lower utilization of sun protection factor > 25 (78% vs. 100%) and lower use on all exposed areas (67% vs. 87%). Sun protection behaviours were also suboptimal in KTRLHIV compared with the matched cohort, with regard to avoiding direct sun exposure ( = 0.003), and dressing to protect from the sun ( < 0.001).
Our findings reveal lower rates of skin cancer protection advice for KTRLHIV compared with matched HIV-negative KTR, likely translating into decreased sunscreen use and suboptimal sun protection behaviours. Addressing this disparity through skin cancer prevention, self-skin examination education and improved dermatology referrals is necessary.
免疫抑制药物是肾移植受者（KTR）患皮肤癌的重要风险因素。与HIV相关的免疫缺陷以及肾移植所需的免疫抑制都会增加皮肤癌的发病率。感染HIV的肾移植受者（KTRLHIV）必须采取措施通过预防来将患皮肤癌的风险降至最低。
开展一项横断面研究，调查KTRLHIV与匹配的HIV阴性KTR队列相比的光保护知识与行为以及皮肤癌知晓情况。
我们在英国一家三级HIV肾移植中心进行的研究，使用了经过验证的关于阳光光保护和皮肤癌知晓情况的在线或面对面调查问卷。KTRLHIV队列（n = 27）和HIV阴性KTR队列（n = 25）在年龄、性别、种族和移植后的年份方面进行了匹配。
只有60%的KTRLHIV看过皮肤科医生，而匹配的KTR队列中这一比例为81%。52%的KTRLHIV接受过防晒建议，显著低于匹配队列中的80%（P = 0.03），主要来源是肾病学家或皮肤科医生。KTRLHIV总体上防晒霜使用率较低（33%对60%，P = 0.05），每日使用者较少（22%对27%），防晒系数>25的使用率较低（78%对100%），在所有暴露部位的使用率也较低（67%对87%）。与匹配队列相比，KTRLHIV在避免直接阳光照射（P = 0.003）和穿着防晒衣物（P < 0.001）方面的防晒行为也不理想。
我们的研究结果显示，与匹配的HIV阴性KTR相比，KTRLHIV接受皮肤癌防护建议的比例较低，这可能导致防晒霜使用减少和防晒行为不理想。通过皮肤癌预防、自我皮肤检查教育和改善皮肤科转诊来解决这一差异是必要的。
