1. Cutaneous complications of immunosuppression in 812 transplant recipients: a 40-year single center experience
- Author
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Giulia Maria Ravaioli, Annalisa Patrizi, Federico Bardazzi, Salvatore Domenico Infusino, Camilla Loi, Bianca Maria Piraccini, and Infusino SD, Loi C, Ravaioli GM, Piraccini BM, Bardazzi F, Patrizi A.
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Population ,Dermatology ,Lower risk ,Single Center ,Skin Diseases ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,medicine ,Humans ,education ,Aged ,Retrospective Studies ,Immunosuppression Therapy ,education.field_of_study ,business.industry ,Actinic keratosis ,Immunosuppression ,Organ Transplantation ,Middle Aged ,medicine.disease ,Tacrolimus ,Female ,Skin cancer ,business ,Solid organ transplantation ,Immunosuppressive Agents ,oral transplant, nonmelanoma skin cancers,actinic keratoses, immunosuppressant drugs, tacrolimus, cyclosporine A - Abstract
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.
- Published
- 2020
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