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Alves FFC, de Jesus LCB, Cristelli MP, Enokihara MMSES, Hirata SH, Facina ADS, Tomimori J. Metastasis of skin squamous cell carcinoma in kidney transplant recipients. Int J Dermatol 2024; 63:560-564. [PMID: 38263692 DOI: 10.1111/ijd.17029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/14/2023] [Accepted: 01/04/2024] [Indexed: 01/25/2024]
Abstract
Cutaneous squamous cell carcinoma (cSCC) is the most common skin malignancy in kidney transplant recipients (KTRs) as a result of immunosuppression. A worldwide increase in kidney transplantation justifies the determination of prognostic biomarkers by collecting detailed patient data on metastasis development. This study aims to characterize the clinical, epidemiological, and histopathological profiles of KTRs who developed metastasis of cSCC. We conducted a retrospective single-center study on 18 KTRs and 21 immunocompetent patients (ICs) with metastatic cSCC, using data from 2004 to 2021. ICs were older (median age 70.5 years) than KTRs (median age: 59.5 years). Both groups were predominantly male with Fitzpatrick skin phototype I/II. The primary tumor appeared around 83.5 months post-transplant, usually in sun-exposed areas (61.1%), though some non-exposed areas in ICs (23.8%) contradicted literature findings. KTRs took longer to develop metastasis (median: 11.0 months) compared to ICs (median: 5.5 months). The mean size of the primary tumor was smaller in KTRs (2.50 cm2) compared to ICs (4.55 cm2). The main lymph node chain affected by metastasis was parotid lymph nodes in KTRs (27.8%) and cervical/axillar lymph nodes in ICs (both 19.0%). Both groups exhibited similar primary tumor grades and metastasis evolution, but KTRs had a higher prevalence of lymphovascular invasion. Metastasis of cSCC was more common in males with low skin phototype, in KTRs, particularly on the head and neck. The study suggests a possible link between lymphovascular invasion and metastasis development in KTRs.
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Affiliation(s)
| | - Laura C B de Jesus
- Department of Medicine, Post Graduate Program in Translational Medicine, São Paulo, Brazil
| | | | - Milvia M S E S Enokihara
- Department of Pathology - Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Sérgio H Hirata
- Department of Dermatology - Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP) and Hospital São Paulo, São Paulo, Brazil
| | - Anamaria da Silva Facina
- Department of Dermatology - Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP) and Hospital São Paulo, São Paulo, Brazil
| | - Jane Tomimori
- Department of Dermatology - Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP) and Hospital São Paulo, São Paulo, Brazil
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Tzadok R, Isman G, Baruch R, Goykhman Y, Ovdat E, Lubezky N, Rishpon A, Grupper A. Cutaneous Malignancies After Kidney and Simultaneous Pancreas-Kidney Transplantations. Transplant Proc 2021; 53:2369-2376. [PMID: 34399970 DOI: 10.1016/j.transproceed.2021.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/19/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Organ transplant recipients are at increased risk of nonmelanotic skin cancers (NMSC). Scarce data exist regarding secondary malignancies developing post-simultaneous pancreas-kidney (SPK) transplantations. Our aim was to assess long-term risk of skin cancers among kidney alone (KA) and SPK transplantation recipients. METHODS In this study, 521 patients who underwent KA or SPK transplantation at our medical center were observed up by dedicated nephrologists and dermatologists. SPK transplantation recipients were matched with a control group of KA transplantation recipients based on demographic and clinical data. A multivariate analysis was performed to find independent cancer risk factors. RESULTS Patients who developed skin cancer were generally older, had a fair skin type, and had a higher incidence of NMSC before transplantation. Older age and fair skin type were independent risk factors on multivariate analysis. SPK transplantation in itself was not an independent risk factor. Cancer recurrence was associated with older age and male sex. Darker skin type and lowered immunosuppressive burden were protective. CONCLUSION In contrast to previous studies, the use of antithymocytic agents or SPK transplantation were not independently associated with increased skin cancer risk in this multivariate analysis. These findings emphasize the complex interplay between posttransplantation NMSC and various clinical and epidemiologic risk parameters.
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Affiliation(s)
| | | | - Roni Baruch
- Organ Transplantation Unit, Surgical Division; Nephrology, Tel Aviv Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | | | - Nir Lubezky
- Organ Transplantation Unit, Surgical Division
| | | | - Ayelet Grupper
- Organ Transplantation Unit, Surgical Division; Nephrology, Tel Aviv Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Rogel CS, de Souza-Santana FC, Marcos EVC, Ogawa MM, Basso G, Tomimori J. HLA alleles in renal transplant recipients with nonmelanoma skin cancer in southeastern Brazil. An Bras Dermatol 2019; 94:287-292. [PMID: 31365656 PMCID: PMC6668948 DOI: 10.1590/abd1806-4841.20197322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 10/29/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Renal transplant recipients are submitted to immunosuppression to avoid graft rejection, which makes them susceptible to various conditions. Furthermore, these individuals present malignant tumors more frequently than the general population, including nonmelanoma skin cancer. The individual genetic basis that acts in the pathogenesis of cutaneous cancer may present a protection or susceptibility factor for disease development. One of these factors is the HLA complex. OBJECTIVE To investigate HLA alleles association to the occurrence of nonmelanoma skin cancer in renal transplant recipients from São Paulo State. METHODS A total of 213 patients (93 renal transplant recipients with nonmelanoma skin cancer and 120 renal transplant recipients without nonmelanoma skin cancer) were evaluated by retrospective and cross-sectional study. Epidemiological, clinical and HLA typing data were found in databases. HLA class I (A, B) and class II (DR) alleles were compared to establish their association with nonmelanoma skin cancer. RESULTS Comparing renal transplant recipients with and without nonmelanoma skin cancer, the HLA-B*13 allele was associated with higher risk of developing nonmelanoma skin cancer while B*45 and B*50 alleles were associated with protection. STUDY LIMITATIONS The HLA A, B and DR alleles identification for the kidney transplantation routine is done by low and medium resolution techniques that do not allow discrimination of specific alleles. CONCLUSION The involvement of HLA alleles in nonmelanoma skin cancer in renal transplant recipients was confirmed in this study. Renal transplant recipients with HLA-B*13 showed higher risk for developing a skin cancer (OR= 7.29) and should be monitored for a long period of time after transplantation.
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Affiliation(s)
| | | | | | | | - Geovana Basso
- Outpatient clinic of post-transplant, Hospital do Rim e
Hipertensão, São Paulo (SP), Brazil
| | - Jane Tomimori
- Department of Dermatology, Universidade Federal de São
Paulo, São Paulo (SP), Brazil
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Billis A, Freitas L, Costa L, Barreto I, Asato M, Araujo K, Losada D, Herculiani A, Tabosa G, Zaidan B, Oliveira G, Bastos L, Rocha R. Genitourinary Malignancies in Transplant or Dialysis Patients: The Frequency of Two Newly Described 2016 World Health Organization Histopathologic Types. Transplant Proc 2017; 49:1783-1785. [DOI: 10.1016/j.transproceed.2017.06.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 05/18/2017] [Accepted: 06/01/2017] [Indexed: 11/27/2022]
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Ferreira FR, Ogawa MM, Nascimento LFC, Tomimori J. Risk factors for nonmelanoma skin cancer in renal transplant recipients: a case-control study from a reference outpatient clinic in Southeast Brazil. Int J Dermatol 2017; 56:154-160. [DOI: 10.1111/ijd.13508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 10/06/2016] [Accepted: 10/18/2016] [Indexed: 10/20/2022]
Affiliation(s)
| | - Marilia M. Ogawa
- Department of Dermatology; Federal University of São Paulo (UNIFESP); São Paulo Brazil
| | | | - Jane Tomimori
- Department of Dermatology; Federal University of São Paulo (UNIFESP); São Paulo Brazil
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EXP CLIN TRANSPLANTExp Clin Transplant 2016; 14. [DOI: 10.6002/ect.tondtdtd2016.p36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Gonçalves CP, Trope BM, Ramos-E-Silva M. Non-melanoma skin cancer in renal transplant recipients: a study in a Brazilian reference center. Clin Cosmet Investig Dermatol 2015; 8:339-44. [PMID: 26185461 PMCID: PMC4501684 DOI: 10.2147/ccid.s78456] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Non-melanoma skin cancer (NMSC) after kidney transplantation is common and can result in significant morbidity and mortality. Their incidence and risk factors in renal transplant recipients (RTRs) vary depending on geographic location and there is a scarcity of literature describing the features of NMSC in Brazil. METHODS NMSC data were retrospectively reviewed in charts of RTRs at the Clementino Fraga Filho University Hospital from January 2004 to December 2005, with the objectives of: 1) evaluating the occurrence of NMSC in RTRs transplanted between 2004 and 2005 at a reference center in Brazil; 2) verifying the frequency of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in these patients according to sex, race, age, and tumor site; and 3) determining the time between transplantation and neoplasia. RESULTS We found 202 RTRs, with 165 suitable for the study. There were 19 NMSC in eleven patients (6.67%), at a mean time of 37.7 months after transplantation. The mean follow-up time was 72.7 months. The ratio of SCC:BCC was 1.1:1. White race and age ≥40 years were associated with a higher incidence of NMSC and they appeared predominantly in sun-exposed sites. CONCLUSION Regular dermatological follow-up of RTRs can help to make earlier diagnoses, resulting in better quality of life and lower morbidity and mortality.
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Affiliation(s)
| | - Beatriz Moritz Trope
- Sector of Dermatology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Ramos-E-Silva
- Sector of Dermatology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Hayashida MZ, Fernandes VMC, Fernandes DRDM, Ogawa MM, Tomimori J. Epidemiology and clinical evolution of non-melanoma skin cancer in renal transplant recipients: a single-center experience in São Paulo, Brazil. Int J Dermatol 2015; 54:e383-8. [PMID: 25969871 DOI: 10.1111/ijd.12632] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Revised: 11/09/2013] [Accepted: 12/31/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND Non-melanoma skin cancer (NMSC) is very common among renal transplant recipients (RTRs) as a result of the immunosuppressed status of these patients and other factors. Few studies have examined the clinical characteristics and evolution of NMSC in RTRs in tropical countries. OBJECTIVES The aim of this study was to characterize the epidemiology and clinical evolution of NMSC in RTRs. METHODS We conducted a retrospective study including 68 RTRs with NMSC diagnosed from July 2004 to December 2009 with a minimum follow-up of three years. We analyzed demographic and transplant- and NMSC-related data. RESULTS The mean age of patients at the first diagnosis of NMSC was 51 years (range: 29-71 years). Most first diagnoses occurred within nine years post-transplant. The majority of patients (n = 48) had Fitzpatrick skin phototype II, although NMSC was also observed in those with skin phototypes III and IV. Forty-six (67.6%) RTRs had received a kidney from a living donor. Fifty-five (80.9%) RTRs had received cytotoxic immunosuppressives, 51 (75.0%) had received calcineurin inhibitors, and two (2.9%) had received mTOR inhibitors. Most of the RTRs developed about eight NMSC lesions, but up to 25 NMSC lesions were diagnosed in one patient. Most lesions (67.6%) were located on sun-exposed areas. Squamous cell carcinoma (SCC) represented the predominant tumor type, accounting for 70.6% of all tumors, whereas basal cell carcinoma accounted for 29.4% of all tumors. Invasive SCC predominated over in situ SCC. Finally, 48.5% of patients had a previous history of viral warts. CONCLUSIONS Long-term use of immunosuppressive therapy increases the risk for tumor occurrence. Multiple NMSC tumors can develop in patients in tropical countries, even in patients with a high skin phototype. Therefore, RTRs should understand the high risk for the development of malignant tumors and should be properly informed about the prevention and treatment of NMSC.
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Affiliation(s)
- Marina Zoega Hayashida
- Department of Dermatology, Escola Paulista de Medicina (Paulista School of Medicine), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Victor Miguel Coutinho Fernandes
- Department of Dermatology, Escola Paulista de Medicina (Paulista School of Medicine), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Diana Rosa de Melo Fernandes
- Department of Dermatology, Escola Paulista de Medicina (Paulista School of Medicine), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Marília Marufuji Ogawa
- Department of Dermatology, Escola Paulista de Medicina (Paulista School of Medicine), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Jane Tomimori
- Department of Dermatology, Escola Paulista de Medicina (Paulista School of Medicine), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
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Ferreira FR, Ogawa MM, Nascimento LFC, Tomimori J. Epidemiological profile of nonmelanoma skin cancer in renal transplant recipients: experience of a referral center. An Bras Dermatol 2015; 89:745-50. [PMID: 25184913 PMCID: PMC4155952 DOI: 10.1590/abd1806-4841.20142590] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 05/05/2013] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Nonmelanoma skin cancer is the most common form of cancer in humans and also the
malignant disease that is increasingly common among kidney transplant
recipients. OBJECTIVE To determine the epidemiological characteristics of renal transplant recipients
with nonmelanoma skin cancer seen at a referral transplantation center. METHODS Cross-sectional descriptive study with renal transplant recipients presenting
nonmelanoma skin cancer, treated at a transplantation referral center between
08/01/2004 and 08/31/2009. Analyzed variables were: gender, age, skin phototype,
occupational and recreational sun exposure, use of photoprotection, personal and
family history of non-melanoma skin cancer, clinical type and location, time
between transplantation and the appearance of the first nonmelanoma skin cancer,
occurrence of viral warts, timing of transplantation, type of donor, cause of
kidney failure, previous transplants, comorbidities, pre-transplant dialysis, type
and duration of dialysis. RESULTS 64 subjects were included. Males - 71.9%; low skin phototypes (up to Fitzpatrick
III) - 89%; mean age - 57.0 years - and mean age at transplant - 47.3 years; sun
exposure - 67.2% occupational - and 64.1% recreational; photoprotection - 78.2%
(although only 34.4% in a regular manner); squamous cell carcinoma - 67.2%;
squamous cell carcinoma/basal cell carcinoma ratio - 2:1; personal history of
nonmelanoma skin cancer - 25% - and family history - 10.9%; location at
photoexposed area - 98.4%; average latency time between transplantation and first
nonmelanoma skin cancer appearance - 78.3 months; viral warts (HPV) after
transplant - 53.1%; average timing of transplantation - 115.5 months; living donor
- 64.1%; triple regimen (antirejection) - 73.2%; comorbidities - 92.2%;
pre-transplant dialysis - 98.4%; hemodialysis - 71.7%; average duration of
dialysis - 39.1 months; previous transplants - 3.1%; hypertension as cause of
renal failure - 46.9%. CONCLUSION This study allowed the epidemiological characterization of a population of kidney
transplant recipients with nonmelanoma skin cancer.
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Affiliation(s)
| | | | | | - Jane Tomimori
- Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Hsiao FY, Hsu WWY. Epidemiology of post-transplant malignancy in Asian renal transplant recipients: a population-based study. Int Urol Nephrol 2013; 46:833-8. [PMID: 24009082 DOI: 10.1007/s11255-013-0544-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 08/14/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Using Taiwan's National Health Insurance Research Database, this large population-based study was conducted to explore the incidences and risk factors of post-transplant malignancy in Asian renal transplant recipients. PATIENTS AND METHODS A total of 642 patients who firstly underwent renal transplant between January 1, 2000 and December 31, 2008 were identified from a 2 million cohort. The primary endpoint was a subsequent hospitalization with a primary diagnosis of malignancy (ICD-9-CM code: 140.xx-239.xx) after renal transplantation. All patients were followed until the occurrence of endpoints or the end of the study (December 31, 2010), whichever came first. Adjusted risks of post-transplant cancer were analyzed using Cox proportional hazards regression model. All models were adjusted for baseline characteristics, comorbid diseases, transplant year, and exposure to immunosuppressive agents. RESULTS Among 642 renal transplant patients, 54 cancers (8.4 %) were identified. The median time between transplant and cancer diagnosis was 46.2 (range 8.5-107.4) months. Cancers of kidney and other unspecified urinary organs was the most common cancer sites, accounted for 18.5 % of the malignancies diagnosed. The next most common cancer sites were trachea, bronchus, and lung (14.8 %), bladder (13.0 %), liver and intrahepatic bile ducts (11.1 %), colon (5.6 %), and prostate (5.6 %). Age at transplantation was a statistically significant risk factor of post-transplant cancer in our study. Increased risks of post-transplant cancer were observed in patients who received immunosuppression agents (cyclosporine (HR 1.26, 95 % CI 0.58-2.77, p = 0.5603), tacrolimus (HR 1.99, 95 % CI 0.66-6.00, p = 0.2197), and mycophenolate (HR 1.00, 95 % CI 0.40-2.45, p = 0.9874)) although the estimates were not statistically significant. CONCLUSIONS Our population-based cohort study offers additional insight into post-transplant cancers in Asian population. Further studies are warranted to assess the association between specific immunosuppression agents and post-transplant cancers.
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Affiliation(s)
- F Y Hsiao
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, 1 Jen-Ai Road, Section 1, Taipei, 10051, Taiwan,
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Karczewski M, Stronka M, Karczewski J, Wiktorowicz K. Skin cancer following kidney transplantation: a single-center experience. Transplant Proc 2012; 43:3760-1. [PMID: 22172842 DOI: 10.1016/j.transproceed.2011.08.080] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 08/30/2011] [Indexed: 10/14/2022]
Abstract
One of the major problems associated with prolonged immunosuppression is a high occurrence of skin malignancies among kidney recipients. Studies have shown that nonmelanoma skin cancer is the most frequently occurring tumor after organ transplantation. The aim of this study was to determine the incidence of and identify possible risk factors for skin malignancies among a population of kidney recipients. This retrospective, single-center cohort comprised 1672 patients transplanted from 1994 to 2011. Only patients with a confirmed diagnosis of skin cancer were selected for medical records review. Among 836 kidney transplant recipients remaining under our care since 1994, skin malignancies were diagnosed in 16 patients (1.9%). The histological diagnoses included squamous cell carcinoma (n=8; 50.0%); basal cell carcinoma (n=6; 37.5%) or malignant melanoma (n=2; 12.5%). The slightly lower incidence of skin malignancies noted in our study compared with other reports might result from differences in the length of follow-up. Some patients diagnosed with skin cancer were treated in local dermatology clinics. Also, a lower exposure to the sun characteristic for the latitude and differences in immunosuppressive therapies could be partially responsible for the lower skin cancer incidence. We also did not observe any association between other reported risk factors, such as age, human leukocyte antigen mismatch, duration of pretransplant hemodialysis, particular immunosuppressive therapies and the skin cancer occurrence among our kidney recipients.
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Affiliation(s)
- M Karczewski
- Department of Transplantology and General Surgery, District Hospital in Poznan, and Poznan University of Medical Sciences, Poznan, Poland.
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Chen QP, Aw DCW. Epidemiology of Skin Diseases in Renal Transplant Recipients in a Tertiary Hospital. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2010. [DOI: 10.47102/annals-acadmedsg.v39n12p904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Introduction: There is no published epidemiological data on skin diseases in kidney transplant recipients in this tropical country, which has multi-ethnic groups with the Chinese as the predominant ethnic group. Materials and Methods: Skin diseases of 143 renal transplant recipients were studied in a skin clinic of a tertiary institution during annual surveillance visits from June 2006 to March 2009. Results: Our study showed that except the common drug specific skin manifestations, sebaceous hyperplasia (56.6%), seborrheic keratosis (60.8%), melanocytic naevi (76.9%), skin tags (37.1%) and viral (29.4%) and fungal (20.3%) infections were the most prevalent skin diseases among renal transplant recipients living in Singapore. The prevalence of pre-malignant and malignant tumours was very low (11.2% actinic keratosis, 1.4% Bowen’s disease, 1.4% squamous cell carcinoma, 0.7% basal cell carcinoma, 0.7% keratoacanthoma). Male predominance was seen in sebaceous hyperplasia (72.4% vs 32.1%), actinic keratosis (17.2% vs 1.8%), viral (36.8% vs 19.6%) and fungal (27.6% vs 8.9%) infections. Our study also showed increased prevalence of sebaceous hyperplasia with increased age but its prevalence was significantly higher than that reported in the age matched general population. The prevalence of seborrheic keratosis, actinic keratosis and viral infection correlated positively with post-transplant duration. Conclusions: Our study provides epidemiological data for the prevalence of skin diseases in renal transplant recipients. It emphasises the importance of dermatologic follow-up for renal transplant patients in order to obtain a diagnosis and manage treatable skin diseases.
Keywords: Actinic keratosis, Sebaceous hyperplasia, Seborrheic keratosis
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Proteomic profiling of renal allograft rejection in serum using magnetic bead-based sample fractionation and MALDI-TOF MS. Clin Exp Med 2010; 10:259-68. [PMID: 20376689 DOI: 10.1007/s10238-010-0094-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Accepted: 03/15/2010] [Indexed: 02/06/2023]
Abstract
Proteomics is one of the emerging techniques for biomarker discovery. Biomarkers can be used for early noninvasive diagnosis and prognosis of diseases and treatment efficacy evaluation. In the present study, the well-established research systems of ClinProt Micro solution incorporated unique magnetic bead sample preparation technology, which, based on matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS), have become very successful in bioinformatics due to its outstanding performance and reproducibility for discovery disease-related biomarker. We collected fasting blood samples from patients with biopsy-confirmed acute renal allograft rejection (n = 12), chronic rejection (n = 12), stable graft function (n = 12) and also from healthy volunteers (n = 13) to study serum peptidome patterns. Specimens were purified with magnetic bead-based weak cation exchange chromatography and analyzed with a MALDI-TOF mass spectrometer. The results indicated that 18 differential peptide peaks were selected as potential biomarkers of acute renal allograft rejection, and 6 differential peptide peaks were selected as potential biomarkers of chronic rejection. A Quick Classifier Algorithm was used to set up the classification models for acute and chronic renal allograft rejection. The algorithm models recognize 82.64% of acute rejection and 98.96% of chronic rejection episodes, respectively. We were able to identify serum protein fingerprints in small sample sizes of recipients with renal allograft rejection and establish the models for diagnosis of renal allograft rejection. This preliminary study demonstrated that proteomics is an emerging tool for early diagnosis of renal allograft rejection and helps us to better understand the pathogenesis of disease process.
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