ORIGINAL ARTICLE   Free

Giornale Italiano di Dermatologia e Venereologia 2020 October;155(5):662-8

DOI: 10.23736/S0392-0488.18.06091-1

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Cutaneous complications of immunosuppression in 812 transplant recipients: a 40-year single center experience

Salvatore D. INFUSINO, Camilla LOI, Giulia M. RAVAIOLI ✉, Bianca M. PIRACCINI, Federico BARDAZZI, Annalisa PATRIZI

Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy

BACKGROUND: As a consequence of the improvement in survival after solid organ transplantation, to visit transplant recipients with neoplastic and non-neoplastic skin disorders due to immunosuppressive treatment has become common for dermatologists.
METHODS: Our endpoints were: 1) to investigate the most common skin diseases in a population of transplant recipients; 2) their associations with the type of immunosuppressant or transplant received; and 3) to compare our single center 40-year experience with the literature data. We retrospectively analyzed the clinical details of the adult patients transplanted in the years 1974-2014, visited for consultation at the Unit of Dermatology of our hospital.
RESULTS: Pathologic conditions were observed in more than 3/4 of 812 adults during the follow-up (mean 12.1 years): nonmelanoma skin cancers or actinic keratoses were seen in 44.0% (N.=357) of patients, non-neoplastic events in 55.2% (N.=448). Heart transplant had the statistically significant highest rate of NMSC and AK (52.6%, P=0.0352). Patients receiving cyclosporine A developed at least one non-melanoma skin cancer or actinic keratosis in 57.7% of cases (P=0.0001), while tacrolimus showed a lower risk (33%, P=0.0001).
CONCLUSIONS: As transplant recipients are susceptible to skin changes, especially after immunosuppressant treatments, a dermatological follow-up should be scheduled for each patient.

KEY WORDS: Transplants; Skin neoplasms; Immunosuppression