Dermatological disease in heart and lung transplant recipients: A cross-sectional and prospective study

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 of skin diseases (malignant and non-malignant) and their prevalence, incidence and 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 between March 2016 and February 2017. 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. Prevalence and incidence of skin disease will be calculated by logistic regression analysis and Kaplan-Meier analysis will be employed for pre-transplant risk factors with comparisons by log-rank.
Results: From preliminary results it was found that 179 dermatological diagnoses were made in 90 of 103 patient encounters (87%). Biopsy proven malignant diagnoses include 13 basal cell carcinomas, 37 squamous cell carcinomas, 1 pleomorphic sarcoma and 1 malignant melanoma. A range of other infectious and inflammatory disorders were diagnosed.

Dr. Nicholas De Rosa

Department of Dermatology, St. Vincent's Hospital Sydney