Poster Presentation Australasian Society for Dermatological Research Annual Scientific Meeting 2017

Dermatological disease in heart and lung transplant recipients: A cross-sectional study (#35)

Nicholas F De Rosa 1 , Vanessa Paddon 1 , Allan Glanville 2 , Kurosh Parsi 1
  1. Department of Dermatology, St Vincent's Hospital, Sydney, NSW, Australia
  2. Department of Thoracic Medicine, St Vincent's Hospital, Sydney, NSW, Australia

Background:

Skin disease is common in solid organ transplant recipients (SOTR). In particular, infectious, pre-malignant and malignant skin diseases are a significant cause of morbidity and mortality in this population.1,2 There are no published Australian data on the rates of non-malignant skin disease in SOTR and there are no prospective studies investigating the rates of skin cancer in Australian heart and lung transplant recipients (HLTR). HLTR are subject to a more profound immunosuppression than other SOTR, which may lead to an increased incidence of cutaneous malignancy and other skin disease.3,4

Objectives:

To examine the spectrum and prevalence of skin diseases (malignant and non-malignant) and their risk factors, in the heart and lung transplant population at St Vincent's Hospital Sydney.

Methods:

Consenting participants were recruited and followed up in the dermatology outpatient clinic over 10 months. Information on participant characteristics and risk factors were gathered from an administered questionnaire and review of case notes. Full skin examination was performed during clinic review and any diagnosed dermatological diseases were recorded. Kaplan-Meier analysis will be employed for pre-transplant risk factors with comparisons by log-rank.

Results:

Ninety-four participants were recruited and there were 147 patient encounters. Skin cancer was diagnosed in 44% of participants over the study period, and 53% had at least one actinic keratosis. The SCC:BCC ratio was 2.6:1. Only 4% of participants were diagnosed with a cutaneous infection. Warts were diagnosed in 15%. These findings are in contrast to previous studies examining skin disease in SOTR, which have found skin infections and viral warts to be the most commonly diagnosed skin conditions.1,4 Risk factor analysis is currently pending.

  1. 1. WISGERHOF, H. C., EDELBROEK, J. R., DE FIJTER, J. W., FELTKAMP, M. C., WILLEMZE, R. & BOUWES BAVINCK, J. N. 2010. Trends of skin diseases in organ-transplant recipients transplanted between 1966 and 2006: a cohort study with follow-up between 1994 and 2006. Br J Dermatol, 162, 390-6.
  2. 2. RASHTAK, S., DIERKHISING, R. A., KREMERS, W. K., PETERS, S. G., CASSIVI, S. D. & OTLEY, C. C. 2015. Incidence and risk factors for skin cancer following lung transplantation. Journal of the American Academy of Dermatology, 72, 92-8.
  3. 3. GJERSVIK, P., HANSEN, S., MOLLER, B., LEIVESTAD, T., GEIRAN, O., SIMONSEN, S., PFEFFER, P. & FAUCHALD, P. 2000. Are heart transplant recipients more likely to develop skin cancer than kidney transplant recipients? Transplant International, 13 Suppl 1, S380-1.
  4. 4. PERERA, G. K., CHILD, F. J., HEATON, N., O'GRADY, J. & HIGGINS, E. M. 2006. Skin lesions in adult liver transplant recipients: a study of 100 consecutive patients. British Journal of Dermatology, 154, 868-72.
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