Dermatological findings observed after renal transplantation in patients

INTRODUCTION: Renal transplant recipients tend to have a variety of skin diseases due to multiple immunosuppressive medications, accompanying co-morbidities and prolonged survival with the transplantation procedure. The aim of this cross-sectional study is to present dermatological findings and the contributing factors in renal transplant recipients.
METHODS: Forty-one renal transplant recipients were examined by dermatologists between February and May 2021. The etiology of the chronic renal failure, the age at the time of the transplantation, time after transplantation, current medications, donor features, sociodemographic features of the patients, history of dialysis and accompanying co-morbidities were questioned.
RESULTS: Average age of patients (27 male, 14 female) was 49.9±11.2 years. Average time after renal transplantation was 12.8±6.6 years. 87.8% of the patients were taking Mycophenolate mofetil; 78% systemic steroids, 68.3% Tacrolimus, 22% Cyclosporin-A and 12.2% Azathioprine. Skin signs due to immunosuppressive medications were more frequent in younger patients (p=0.031). Xerosis of the skin due to immunosuppressive medications was found in 41.5% and acneiform eruption in 34.1% of the patients. For skin infections, superficial fungal infections were the most frequent (73.2%), 56.1% of them being onychomycosis. Warts (22%) were the most frequent viral skin disease (31.7%). Viral and fungal skin infections were significantly more common in patients who are taking Tacrolimus (p=0.024 and p=0.002, respectively). Fungal skin infections were more common in patients with prolonged and high-dose Mycophenolate mofetil treatment (p=0.021 and p=0.005, respectively). Kaposi sarcoma was found in one of the patients and in situ squamous cell carcinoma was found in another patient. The most common oral lesion was gingival hyperplasia (29.3%).
DISCUSSION AND CONCLUSION: Fungal and viral skin infections, skin cancers, acneiform eruptions, xerosis of the skin and gingival hyperplasia are commonly seen in renal transplant recipients. Therefore, proper dermatologic follow-up examinations are crucial.