title: The prevalence of dysplasia and malignant lip lesions in transplant patients.
abstract: BACKGROUND
  Solid organ transplant patients are at an increased risk of developing lip malignancies. The role of HLA mismatch as a risk factor for such changes has only been described in skin.
  
  
  METHODS
  Lip lesions were evaluated in 403 solid organ transplant patients (immunosuppressed for at least 3 months) and findings compared to age and sex matched, otherwise healthy patients who acted as controls. HLA typing was provided for the transplant patients. All patients provided details of smoking history, alcohol consumption, skin type, as assessed by ease of burning to sunlight, and exposure to sunlight or other forms of ultraviolet radiation.
  
  
  RESULTS
  Lip lesions were identified in 36 transplant patients and 29 were biopsied. Fourteen of the biopsies confirmed dysplastic or malignant changes. For the control patients, one lesion was identified as dysplastic. The prevalence of dysplastic and malignant lip lesions was significantly higher (P = 0.006) in the transplant patients when compared to controls. Risk factors for dysplastic/malignant changes in the transplant group included age (P = 0.01), smoking (P = 0.033) and HLA-B mismatch (P = 0.001). Lip covering provided a significant reduction (P = 0.045) in the development of lip changes.
  
  
  CONCLUSIONS
  All transplant patients should be regularly screened for lip malignancies and consulted on smoking and sunlight exposure. HLA-B mismatch does appear to make these patients more susceptible to dysplastic/malignant changes.
authors: Sir John Walsh Research Institute, Department of Oral Diagnostic & Surgical Sciences, School of Dentistry, Dunedin, New Zealand.
authors: Anita
authors: A
authors: Nolan
authors: Nick M
authors: NM
authors: Girdler
authors: Robin A
authors: RA
authors: Seymour
authors: J Mark
authors: JM
authors: Thomason
mesh_terms: D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D016022:Case-Control Studies; D004739:England / Q000453:epidemiology; D004781:Environmental Exposure / Q000706:statistics & numerical data; D005260:Female; D006680:HLA Antigens / Q000276:immunology; D015234:HLA-A Antigens / Q000032:analysis; D015235:HLA-B Antigens / Q000032:analysis; D006684:HLA-DR Antigens / Q000032:analysis; D006650:Histocompatibility Testing / Q000706:statistics & numerical data; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000706:statistics & numerical data; D008048:Lip Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000706:statistics & numerical data*; D011230:Precancerous Conditions / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012880:Skin Pigmentation; D012907:Smoking / Q000453:epidemiology; D013472:Sunlight; D013473:Sunscreening Agents / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D006680:HLA Antigens; D015234:HLA-A Antigens; D015235:HLA-B Antigens; D006684:HLA-DR Antigens; D007166:Immunosuppressive Agents; D013473:Sunscreening Agents