Study of dermatoses in kidney transplant patients

An Bras Dermatol. 2013 May-Jun;88(3):361-7. doi: 10.1590/abd1806-4841.20131859.

Abstract

Background: The increasing in the number of kidney transplant recipients has favored, more frequently than before, the emergence of dermatoses and warranted their study through subsequent publications.

Objectives: to evaluate the frequency of dermatoses in kidney transplant recipients.

Methods: kidney transplant recipients with suspected dermatoses between March 1st 2009 and June 30th 2010.

Results: 53 patients (28 males and 25 females), aged between 22 and 69 (mean age = 45 years) were evaluated. Most of them came from the cities of Ceilândia, Samambaia and São Sebastião/DF, and had already been transplanted for 5 to 10 years before (37.7%); 62.3% were recipients of living donors and 83% were prednisone-treated. The most prevalent dermatoses were of fungal (45.3%) and viral (39.6%) etiologies. Among the non-melanoma malignant neoplasms, the basal cell carcinoma prevailed (six cases), in spite of the low incidence. Concerning fungal dermatoses, 12 cases of onychomycosis, five of pityriasis versicolor and four of pityrosporum folliculitis were reported. For diagnosis, in most cases (64.2%), laboratory examinations (mycological and histopathological) were performed.

Conclusion: cutaneous manifestations in kidney transplant recipients are generally secondary to immunosuppression. The infectious dermatoses, especially those of fungal origin, are frequently found in kidney transplant recipients and their occurrence increases progressively according to the time elapsed from the transplantation, which makes follow-up important.

FUNDAMENTOS: o crescente aumento do número dos transplantados renais tem favorecido o aparecimento mais frequente das dermatoses e permitido o estudo em sucessivos trabalhos.

OBJETIVOS: avaliar a frequência das dermatoses em pacientes transplantados renais.

MÉTODOS: captação de pacientes transplantados renais durante o período de 1° de março de 2009 a 30 de junho de 2010 com suspeita de dermatoses.

RESULTADOS: : foram avaliados 53 pacientes (28 homens e 25 mulheres), entre 22 e 69 anos (com uma média de 45 anos), a maioria procedente de Ceilândia, Samambaia e São Sebastião/DF, entre 5 e 10 anos de transplante renal (37,7%), sendo 62,3% receptor de doador vivo e 83% em uso de prednisona. As dermatoses mais prevalentes foram as de etiologia fúngica (45,3%) e viral (39,6%). Das neoplasias malignas não-melanoma, apesar da baixa incidência, predominou o carcinoma basocelular (seis casos). Com relação s dermatoses de origem fúngica, ocorreram 12 casos de onicomicoses, cinco casos de pitiríase versicolor e quatro casos de foliculite pitirospórica. Para realização do diagnóstico, na maioria dos casos (64,2%), foi utilizado os exames laboratoriais ( micológicos e histopatológicos).

CONCLUSÃO: as manifestações cutâneas em pacientes transplantados renais são geralmente secundárias imunossupressão. As dermatoses infecciosas, principalmente as de etiologia fúngica, são frequentes em pacientes transplantados renais, e sua ocorrência aumenta progressivamente, conforme o tempo transcorrido, a partir do transplante, sendo importante o acompanhamento.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Inflammatory Agents / adverse effects
  • Brazil / epidemiology
  • Cross-Sectional Studies
  • Dermatomycoses / epidemiology
  • Female
  • Humans
  • Immunosuppression Therapy / adverse effects*
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / statistics & numerical data
  • Male
  • Middle Aged
  • Prednisone / adverse effects
  • Skin Diseases / epidemiology
  • Skin Diseases / etiology*
  • Skin Diseases, Bacterial / epidemiology
  • Skin Diseases, Viral / epidemiology
  • Socioeconomic Factors
  • Time Factors
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Prednisone

Grants and funding

Financial support: Research Project funded by ESCS/FEPECS.