Introduction: Liver transplantation is often the only remaining therapy for patients with end stage liver cirrhosis, acute liver failure and some metabolic and congenital hepatic diseases. Several factors are known to predict skin complications in liver transplant recipients, especially immunosuppressive regimen, age, sex, viral infections and sun exposure. The aim of this study was to analyze the incidence and risk factors of skin complications in liver transplant recipients.
Materials and Methods: Patients who had skin biopsies were selected among 408 liver transplant recipients from January 1990 to December 2012 in Başkent University. Demographic and clinical findings of these patients, including age, gender, primary liver disease, immunosuppressive therapy and the time between transplantation and cutaneous lesions were examined.
Results: There were 38 patients who had skin biopsy after liver transplantation. The mean age at transplantation was 30.5 years. The primary liver disease was hepatocellular carcinoma seconder to viral hepatitis in 15 patients, Wilson disease in 7 patients, criptogenic cirrhosis in 3, familial hypercholesterolemia in 3 patients, and 1 each patients of Byler disease, Caroli disease, tyrosinemia, Budd-Chiari sendrom, congenital hepatic fibrosis, alcholic cirrhosis, and biliar atresia. The primary disease in 2 patients were unknown. The histologic diagnosis included infectious diseases (n=4); xanthomatous lesions (n=4); vasculopathic lesions (n=4); melanocytic lesions (n=4); precancerous and cancerous lesions (n=3), benign adnexial tumors (n=2); skin atrophy (n=2); calcinosis cutis (n=2), keratinous cyst (n=2) and miscalenous lesions (n=11)
Conclusions: We presented the cutaneous manifestations in liver transplant recipients. The most common skin lesion in these patients were infectious, xanthomatous and melanocytic lesions. Precancerous and cancerous lesions came after these lesions, so our study indicates that the risk for skin malignancy after liver transplantation is lower than the malignancy risk for other solid organ transplants, particularly kidney.