Dermatologic findings in renal transplant recipients: Possible effects of immunosuppression regimen and p53 mutations

Transplant Proc. 2010 Sep;42(7):2538-41. doi: 10.1016/j.transproceed.2010.05.165.

Abstract

Objective: To analyze the dermatologic lesions and possible effects of immunosuppression treatment and p53 gene mutations on dermatologic findings in renal transplant recipients.

Materials and methods: The study included 163 renal transplant recipients. After dermatologic examination, cultures, and histopathologic and genetic analyses were performed. A single-strand conformation polymorphism technique was used to analyze p53 gene mutations. Patients were categorized into 3 groups according to time since the transplantation procedure. Results were analyzed using the χ(2) test, using a software program (SPSS version 13.0; SPSS, Inc, Chicago, Illinois).

Results: Mean (SD) age of the 163 transplant recipients (65 women and 98 men) was 40 (11) years, and posttransplantation follow-up was 65 (55) months. The most frequently observed drug-related lesion was hypertrichosis, in 46 of 150 patients. Of 115 lesions, the most commonly observed were verruca vulgaris (n = 34) from viruses, and pityriasis versicolor (n = 21) from superficial fungal infections. Of the total group, 20 patients (12.2%) were mutation carriers. Compared with the entire cohort, the group with premalignant lesions demonstrated more p53 mutations (11% vs 50%; P = .004). Patients given cyclosporine therapy exhibited more premalignant or malignant cutaneous lesions compared with patients who received other agents (P = .03).

Conclusion: Patients carrying p53 mutations developed a malignant lesion in the late posttransplantation period, which suggests the importance of prediction of risk.

MeSH terms

  • Adult
  • Dermatomycoses / epidemiology
  • Drug Therapy, Combination
  • Exons / genetics
  • Female
  • Follow-Up Studies
  • Genes, p53*
  • Humans
  • Immunosuppression Therapy / adverse effects*
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation / immunology*
  • Kidney Transplantation / physiology
  • Male
  • Middle Aged
  • Mutation*
  • Polymorphism, Single-Stranded Conformational
  • Postoperative Complications / genetics
  • Precancerous Conditions / genetics
  • Skin Diseases, Bacterial / epidemiology
  • Skin Diseases, Viral / epidemiology
  • Skin Neoplasms / genetics*
  • Time Factors

Substances

  • Immunosuppressive Agents