Skin lesions in renal transplant recipients: A single center analysis

Background: The chronic use of immunosuppressants in renal transplant recipients (RTRs) predisposes them to a variety of skin manifestations. Studies on skin lesions in RTRs from India have been limited. Aim: To study the prevalence and clinical spectrum of skin diseases in RTR in patients attending the Nephrology clinic of a tertiary care hospital in South India. Methods: Between October 2002 and June 2003, 365 RTRs were evaluated for skin lesions, including 280 examined after renal transplant (group A) and 85 examined once before and then monthly after transplant for a period of 6 months (group B). Results: A total of 1163 skin lesions were examined in 346 RTRs (94.7) including lesions of aesthetic interest (LAI) [62.3] followed by infections [27.3]. All LAI were drug-related manifestations, making it the most common skin lesion, while fungal (58.7) and viral (29.3) infections constituted majority of lesions caused by infection. Lesions related to neoplasms were relatively uncommon (2.1) and all lesions were benign. Miscellaneous lesions constituted 8.3 of skin lesions, which included vaccine-induced necrobiotic granulomas at the site of Hepatitis B vaccination and acquired perforating dermatoses. Conclusion: Skin lesions among RTRs from India consist predominantly of drug-related LAI and infections and are different from the West in view of the paucity of neoplastic lesions.