Skin diseases in children with organ transplants

Background: Skin diseases are frequent in organ transplant recipients, but studies concerning children are sparse. Objective: We assessed skin diseases in children who had received organ transplants. Methods: A total of 145 children referred to our dermatologic consultation were studied. Results: Steroid-induced striae distensae and acne occurred only in adolescents; severe cyclosporine-related side effects were more frequent in younger children. The most common findings were warts (53.8%), tinea versicolor (14.5%), herpes simplex/zoster (9.6%), molluscum contagiosum (6.9%), and impetigo contagiosum and folliculitis (6.2%). Other notable disorders included a diffuse hyperpigmentation with a "dirty" appearance of the skin, pyogenic granulomas, melanocyctic nevi proliferation, and skin tags. Two of 20 further adult patients who received transplants during childhood had squamous cell carcinomas. Conclusion: Children who have received organ transplants frequently present side effects of immunosuppressive drugs and infectious diseases. Most disorders are related to the age of the patients rather than to the length of immunosuppression, whereas others are favored by the reinforcement of immuno-suppression. Skin cancers were not encountered, bur the risk of carcinomas in early adulthood should be considered.