Meta-Analysis
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Feb 26, 2015; 3(1): 11-19
Published online Feb 26, 2015. doi: 10.13105/wjma.v3.i1.11
Risk of infectious diseases and cutaneous tumours in solid organ recipients: A meta-analysis of literature
Paola Savoia, Giovanni Cavaliere, Paolo Fava
Paola Savoia, Giovanni Cavaliere, Paolo Fava, Department of Medical Science, University of Turin, 10126 Torino, Italy
Author contributions: Savoia P and Cavaliere G contributed equally to this work; Savoia P and Cavaliere G designed the research; Savoia P, Cavaliere G and Fava P performed the research, analysed the data and wrote the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Paola Savoia, MD, Department of Medical Science, University of Turin, Via Cherasco 23, 10126 Torino, Italy. paola.savoia@unito.it
Telephone: +39-11-6335849 Fax: + 39-11-674034
Received: July 22, 2014
Peer-review started: July 23, 2014
First decision: August 28, 2014
Revised: September 8, 2014
Accepted: November 17, 2014
Article in press: November 19, 2014
Published online: February 26, 2015
Abstract

AIM: To compare the risk of cutaneous infections and tumours in kidney transplant recipients with data recently published about this topic.

METHODS: In the present work, we evaluated the incidence of bacterial, fungal and viral cutaneous infectious diseases and the development of skin cancers in a cohort of 436 patients who underwent a renal transplantation. The median age at transplantation of our patients was 50 years and the median duration of the immunosuppression was of 7.2 years. Data obtained from our cohort were compared with those obtained by a systematic review of the literature of the last 20 years about the same topic.

RESULTS: Infectious diseases were the most frequent dermatological disorders that were diagnosed after transplantation, affecting about the 16.5% of patients. Herpes virus reactivation occurs in about the 35% of patients and is more common within 6 mo from transplantation, whereas when the immunosuppression is reduced, skin infections are mainly represented by Human Papilloma Virus infections and localized mycosis, such as pityriasis versicolor and superficial candidiasis. Bacterial infections were relatively rare and occur mainly in the first months after transplantation. The cumulative risk to develop skin cancer enhance significantly over the time, as consequence of long-term immunosuppressive regiments. Endogenous and exogenous risk factors, as well as the schedule of immunosuppression can play a role and justify the different incidence of skin cancer in the various series.

CONCLUSION: Skin infections and cancer, commonly diagnosed in transplanted patients, impact on survival and life-quality, justifying the realization of follow-up programs for the early diagnosis and treatment.

Keywords: Skin infectious disease, Cutaneous tumours, Transplantations, Risk, Solid organ recipients

Core tip: Patients who underwent solid organ transplantation frequently suffer from skin infections and malignancies, due to the effects of long-term immunosuppressive therapy. Here, we compare our data about the risk to develop infectious disease and non-melanoma skin cancer in solid organ transplantation recipients, together with a meta-analysis of data recently reported by literature about this topic.