Cutaneous manifestations in renal transplant recipients

Background: Skin lesions both benign and malignant occur frequently in renal transplant recipients receiving long term immunosuppressive drugs. Aim was to study cutaneous manifestations in renal transplant recipients (RTRs).Methods: Thirty two patients with chronic kidney diseases who underwent renal transplant were included in the study. All of the patients were fully examined for cutaneous, hair, nail and mucosal changes. Diagnostic measures such as scraping and biopsy of the lesions was carried out, where necessary.Results: Out of 32 patients, 23 (71.8%) were male and 9 (28.1%) were females. Skin infections occurred in 84.3% of the patients and most of them were fungal infections (37.5%), followed by viral infection in (31.2%) patients. Oral mucosal changes, hair and nail comprising of (34.3%), (71.8%), (43.7%) patients respectively. Only malignancy seen in one patient was basal cell carcinoma. Drug induced cutaneous manifestations were acneiform eruptions (18.75%), hirsutism (15.6%), hypertrichosis (9.3%), striae (6.25%), gingival hyperplasia (3.12%) and skin atrophy (3.12%).Conclusions: Skin lesions are a significant problem in renal transplant recipients. A careful monitoring of these patients is recommended for early diagnosis and treatment.

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A clinical study of cutaneous manifestations in renal transplant recipients

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20190053 ◽

2019 ◽

Vol 5 (1) ◽

pp. 160

Author(s):

Pradeep Vittal Bhagwat ◽

R. Rajagopal ◽

P. S. Murthy ◽

R. S. V. Kumar

Keyword(s):

Renal Transplantation ◽

Renal Transplant ◽

Viral Infections ◽

Fungal Infections ◽

Common Finding ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Drug Induced ◽

Cutaneous Manifestations ◽

Dermatological Examination

Background: Chronic renal failure is becoming common entity with increased incidence of diabetes mellitus and resulting diabetic nephropathy. With the availability of renal transplantation services in many centers, increased availability of donors, improved surgical technique and availability of better drugs, the survival of renal transplant recipients has increased. The objective of the study was to study the cutaneous manifestations in renal transplant recipients.Methods: Fifty consenting, consecutive renal transplant recipients attending the OPD and in-patients at Command Hospital Air Force, Bangalore during July 2001 to March 2003 were included in the study. Detailed history was taken and clinical examination was carried out with special emphasis on the Dermatological examination. Relevant investigations were carried out.Results: A total of 50 renal transplant recipients were studied of which 42 (84%) were males and 8 (16%) were females. The age of patients ranged from 16 years to 60 years. Infections were the most common finding, encountered in 38 (76%) patients, followed by drug induced manifestations in 24 (48%) patients. Cellulitis was noted in 1 (2%) patient, viral infections were seen in 18 (36%) patients, fungal infection was the commonest in this study, encountered in 38 (76%) patients. Monomorphic acne was seen in 13 (26%) patients. Hypertrichosis/hirsutism were the commonest drug induced manifestation in this study, seen in 16 (32%) patients.Conclusions: In patients with renal transplantation, superficial fungal infections and viral infections of the skin are seen more commonly. Monomorphic acne and hypertrichosis due to immunosuppressive are also seen frequently. These changes are moderately influenced by the immunosuppressive regimen used.

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Cutaneous Manifestations in Renal Transplant Recipients

Nepal Journal of Dermatology Venereology & Leprology ◽

10.3126/njdvl.v19i1.35953 ◽

2021 ◽

Vol 19 (1) ◽

pp. 42-49

Author(s):

Anil Kumar Das ◽

Ramesh Sharma ◽

Ashish Karn

Keyword(s):

Renal Transplant ◽

Teaching Hospital ◽

University Teaching ◽

Outpatient Department ◽

Renal Transplant Recipients ◽

Gingival Hyperplasia ◽

Transplant Recipients ◽

Term Survival ◽

Cutaneous Manifestations

Background: The availability of potent immunosuppressants has paved the path towards decreased incidence of graft rejection and long term survival of the renal transplant recipients. But, with the increased life span of the patients and long term use of immunosuppressants, there has been an increase in various skin conditions; ranging from various infections to some life-threatening cutaneous malignancies. Objectives: This study was carried out to determine the pattern of different cutaneous manifestations in renal transplant recipients at Tribhuvan University Teaching Hospital, to identify the infectious and non-infectious skin manifestations in these patients and their relation with the duration of transplantation. Methodology: The present study was a hospital based cross-sectional descriptive study conducted at Tribhuvan University Teaching Hospital, Kathmandu; Department of Internal Medicine, Transplant Outpatient department and Outpatient department of Department of Dermatology from June 2013 to May 2014. A total of 114 renal transplant recipients were enrolled in the study. Results: A total of 114 renal transplant recipients with a mean age of 37.56±11.10 years were studied. The immunosuppressive regimen consisted of combinations including tacrolimus, prednisolone, mycophenolate mofetil/azathioprine along with supportive medications like antivirals, antibiotics and antihypertensives. Out of all those studied, 60 patients had a total of 61 cutaneous manifestations. The mean duration from date of transplantation to presentation to the transplant OPD for infectious dermatoses was 688.4 days (1.88 years) and for iatrogenic dermatoses was 67.5 days. The most common cutaneous manifestation was acne (41%) followed by fungal infections (27.9%) consisting of pityriasis versicolor (n=9), dermatophytosis (n=6) and candidiasis (n=2); viral infections (18%) consisting of verruca (n=4), herpes zoster (n=4) and herpes simplex (n=3); bacterial infections (4.9%) consisting of folliculitis (n=2) and erythema chronicum migrans (n=1). Gingival hyperplasia was observed in a single patient. Other cutaneous manifestations like seborrheic dermatitis and xerosis were also observed in 2 patients each during the study. Conclusion: Renal transplant recipients are susceptible to acquire various cutaneous manifestations as a result of long term immunosuppression and also due to adverse effects of the drugs used. This knowledge helps the transplant physicians for regular dermatologic screening of these patients for early diagnosis and treatment of the skin lesions.

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024 SYSTEMIC FUNGAL INFECTIONS IN RENAL TRANSPLANT RECIPIENTS – 18 YEAR RETROSPECTIVE ANALYSIS

Indian Journal of Transplantation ◽

10.1016/s2212-0017(11)60144-5 ◽

2011 ◽

Vol 5 (1) ◽

pp. 20

Author(s):

Anupama Kaul ◽

RK Sharma ◽

Jai Suresh ◽

Vineeta Agarwal ◽

R Marakh

Keyword(s):

Renal Transplant ◽

Retrospective Analysis ◽

Fungal Infections ◽

Renal Transplant Recipients ◽

Transplant Recipients

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Effects of Rituximab on the Development of Viral and Fungal Infections in Renal Transplant Recipients

ISRN Transplantation ◽

10.5402/2013/819025 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 6

Author(s):

Samir J. Patel ◽

Jennifer M. Devos ◽

Richard J. Knight ◽

Kyle L. Dawson ◽

Wadi N. Suki ◽

...

Keyword(s):

Renal Transplant ◽

Odds Ratio ◽

Viral Infections ◽

Fungal Infections ◽

Graft Function ◽

Deceased Donor ◽

Infectious Complications ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Kidney Transplant Recipients

Background. Rituximab is becoming increasingly utilized in renal transplant recipients; however, its association with infections remains unclear. Methods. We reviewed the incidence of viral and fungal infections in kidney transplant recipients treated with () or without () rituximab (RTX) in addition to standard immunosuppression. Results. Infections occurred in 134 (30%) patients, with a greater proportion in RTX versus no RTX patients (47% versus 28%; ). Viral infections occurred in 44% and 27% of RTX and no RTX patients, respectively (). This was largely driven by the frequency of BK viremia and noncytomegalovirus/non-BK viruses in RTX patients (27% versus 13% () and 15% versus 2% (), resp.). Fungal infections also occurred more often in RTX patients (11% versus 3 %; ). Multivariate analysis revealed deceased donor recipient (odds ratio = 2.5; ) and rituximab exposure (odds ratio = 2.2; ) as independent risk factors for infection. Older patients, deceased donor recipients, those on dialysis longer, and those with delayed graft function tended to be at a greater risk for infections following rituximab. Conclusions. Rituximab is associated with an increased incidence of viral and fungal infections in kidney transplantation. Additional preventative measures and/or monitoring infectious complications may be warranted in those receiving rituximab.

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