A 10-year retrospective cohort study on dermatological conditions in renal transplant recipients at the Charlotte Maxeke Johannesburg Academic Hospital, 2008-2018
Date
2021
Authors
Ede, Roseline Chioma
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Abstract
Introduction: Dermatological conditions are common in renal transplant recipients as aconsequence of chronic immunosuppression. Awareness of these conditions is important to dermatologists as their presentations may be atypical, and their occurrences affect the overall well-being of renal transplant recipients. Aim of study: To describe the spectrum of dermatological conditions observed in renal transplant recipients at Charlotte Maxeke Johannesburg Academic hospital between January 2008 and December 2018. Methods: A retrospective cohort study was performed. All participants aged 18 years and above that received a renal allograft and were followed up at the Renal unit in Charlotte Maxeke Johannesburg Academic Hospital, between January 1, 2008, and December 31, 2018, were recruited. A descriptive analysis of the data was performed. Continuous data were summarised as mean (standard deviation), and median (interquartile range), and categorical data as frequencies and proportions. A test of statistical significance was computed at p less than 0.05. All analyses were performed with Stata Release 15.1. Results: Of all the renal transplant recipients in the study (n=173), 69% developed dermatological conditions during the study period. Twenty-two percent of the dermatological conditions were viral infections; 17% were fungal infections 6% were bacterial infections; 6 % were cutaneous neoplasms, and 17% were adverse drug reactions. Twenty-nine participants had more than one condition. There was a statisticallysignificant difference in dermatological conditions for participants who had infection prophylaxis for six months versus greater than six months, p = .025. There was nostatistically significance difference in dermatological conditions for gender, age, race,aetiology of end-stage renal disease, organ donor type, and type of immunosuppressant drug. There was a trend to more cases of viral infections in males, participants less than 50 years, and participants of African descent but a statistical test of significance was not performed because of small sample size. The median time to develop dermatological conditions was two years. Discussion: The prevalence of dermatological conditions in this study is 69%. The majority ofthese conditions appear to occur between one year to two years following renal transplantation suggesting this may correspond to peak of immunosuppression. Conclusion: This study shows that dermatological conditions are common in renal transplantrecipients. This study also appears to suggest that majority of these dermatological conditions are cutaneous infections and occur at peak of immunosuppression. Cutaneous adverse drug reactions, mostly acneiform eruptions was also noted to be common during the peak of immunosuppression. It is important that patients are aware of these conditions and follow appropriate preventive strategies. It is even more pertinent that dermatologists collaborate with nephrologists in the surveillance and appropriate management of these conditions.
Description
A research report submitted to the Faculty of Health Sciences, University of theWitwatersrand, in partial fulfilment of the requirements for the degree of Master of Medicine (in Dermatology)
Keywords
Dermatological conditions, Renal transplant