Identifying risk factors for cutaneous disease among solid organ transplant recipients: A retrospective review

Chelsea Shope; Laura Andrews; Mary Nan Leath; Courtney Linkous; Lara Wine Lee

doi:10.1016/j.jdin.2023.02.003

Identifying risk factors for cutaneous disease among solid organ transplant recipients: A retrospective review

JAAD Int. 2023 Feb 23:11:157-164. doi: 10.1016/j.jdin.2023.02.003. eCollection 2023 Jun.

Authors

Chelsea Shope¹, Laura Andrews¹, Mary Nan Leath¹, Courtney Linkous¹, Lara Wine Lee²

Affiliations

¹ College of Medicine, Medical University of South Carolina, Charleston, South Carolina.
² Department of Dermatology, Medical University of South Carolina, Charleston, South Carolina.

Abstract

Background: As solid organ transplant recipient (SOTR) life expectancy lengthens, the risk of developing other chronic diseases also increases.

Objective: To determine the cutaneous pathologies for which SOTRs are at an increased risk.

Methods: We performed a retrospective review of SOTRs seen by dermatology from January 1, 2012 and June 1, 2022. Data were analyzed using multivariate logistic regression. Benjamini Hochberg-adjusted P values were examined for multiplicity.

Results: Five hundred and thirty SOTRs were identified. Patients had cutaneous malignancy (38.3%), precancerous lesions (32.5%), inflammatory (35.5%), and infectious diseases (33.1%). Odds of precancerous lesions were higher with increased age at transplant (odds ratio [OR], 1.04; adjusted P =.006), and lower with female sex (OR, 0.505; adjusted P =.006) and African American race (OR, 0.027; adjusted P =.006). Odds of inflammatory lesions were lower with increased age at transplant (OR, 0.979; adjusted P =.023). Odds of infectious diseases were higher with prednisone use (OR, 2.615; adjusted P value =.023).

Limitations: This study is retrospective and was not able to capture patients seen by dermatology outside of our institution.

Conclusions: SOTRs at risk of cutaneous lesions should be referred to dermatology because these conditions may place a significant burden on the quality of life.

Keywords: immunosuppression; infectious; inflammatory; organ transplant; precancer.