[Comparison of the prevalence frequency of infectious skin changes in dialyzed patients and after kidney transplantation].

UNLABELLED: Due to graft preserving immunosuppressive therapy, renal transplant recipients are predisposed to the development of a variety of skin infections and skin cancers. The aim of the study was to compare prevalence frequency of infective skin changes among patients after kidney transplantation and the dialyzed population. Clinical dermatological examination was performed in 486 patients after renal transplantation. The group consisted of 296 men (60.9%) and 190 women (30.1%), of mean age 46.1+/-13.1 (18-74 years) with median time after transplantation of 74.3+/-52.1 months. Most of the patients (80.7%) before transplantation were treated by maintenance hemodialysis. The most frequent immunosuppression regiments were combination of cyclosporine A (CsA) with mycofenolate mofetil (MMF) and steroids (GKS)-207 patients (42.5%); tacrolimus (TAC) with MMF and GKS-102 (20.9%) and CsA with azathiopine and GKS-53 patients (10.9%). The group of 112 dialyzed patients consisted of: 57 males (50.9%) and 55 females (49.1%), aged 57.4+/-15.4 years without history of immunosuppressive therapy and were on maintenance dialysis for 63.2+/-74.0 months. Most of this group (77.7%) was on maintenance hemodialysis, while the remaining 22.3% on peritoneal dialysis. The obtained results were analyzed based on t-Student's, Mann-Whitney's, chi-square and Fisher tests. It was shown that infective skin changes were significantly more frequent in the group of patients after kidney transplantation as compared with the dialyzed population. They were observed in 53.9% and 9.8% of the studied populations, respectively (p<0.0001). In the studied group after kidney transplantation the most frequent were viral changes (38.9%). Fungal infection was observed in 25.9% of these patients, while bacterial in 1.2% of this study group. In the dialyzed population fungal infections were diagnosed in 8.9%, while viral in 3.6% of patients. No bacterial changes were observed in this group. Acne was observed in 16.5% of patients after kidney transplantation.

CONCLUSIONS: 1. In the group of patients after kidney transplantation receiving immunosuppressive therapy viral, fungal and bacterial infective skin changes were significantly more frequent as compared with the dialyzed patients. 2. The most frequent skin changes observed in patients after kidney transplantation were viral warts.