Cutaneous squamoproliferative lesions in renal transplant recipients. Differentiation from lesions in immunocompetent patients.
Of 291 immunosuppressed renal transplant recipients (RTRs) with surviving allografts attending the Royal London Hospital, 171 patients (59%) were found to have warty keratoses. On histological analysis, the lesions in 50 patients (17%) showed partial-thickness dysplasia, and 34 (12%) had one or more invasive squamous cell carcinoma (SCC) and/or one or more in situ SCC or full-thickness dysplasia. We examined the claim that squamoproliferative lesions in RTRs possess distinctive histopathological features that differ from those of similar lesions occurring sporadically in the nonimmunosuppressed population. We compared 40 squamoproliferative lesions from RTRs with 40 matched squamoproliferative lesions from nonimmunosuppressed patients; lesions were coded and their source was unknown to the assessors. Two dermatopathologists independently assessed the cases and gave scores for 11 histological features that have been reported to be characteristic of such lesions in the immunosuppressed population. These included a warty architecture, koilocytes, and multinucleate giant cells. Using these criteria, it was not possible to distinguish lesions of immunosuppressed patients from those of immunocompetent people.
Glover
M
M
Department of Dermatology, Royal London Hospital Trust, Whitechapel, U.K.
Cerio
R
R
Corbett
M
M
Leigh
I
I
Hanby
A M
AM
D002278:Carcinoma in Situ / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D003594:Cytoplasmic Granules / Q000648:ultrastructure; D003937:Diagnosis, Differential; D004848:Epithelium / Q000473:pathology; D005260:Female; D015726:Giant Cells / Q000473:pathology; D006085:Graft Survival; D006801:Humans; D006818:Hyalin / Q000737:chemistry; D007121:Immunocompetence; D007165:Immunosuppression Therapy; D007633:Keratins / Q000032:analysis; D007642:Keratosis / Q000473:pathology*; D016030:Kidney Transplantation; D008297:Male; D009361:Neoplasm Invasiveness; D010212:Papilloma / Q000473:pathology; D012878:Skin Neoplasms / Q000473:pathology; D014184:Transplantation, Homologous; D014860:Warts / Q000473:pathology
C001500:keratohyalin; D007633:Keratins