Back
 JCDSA  Vol.2 No.3 , September 2012
Re-Evaluation of Acquired Epidermodysplasia Verruciformis in Kidney Transplant Recipients
Abstract: Background: Epidermodysplasia verruciformis (EV) is a skin disease associated with numerous early onset viral warts on the sun exposed parts of the body that usually progress into different skin malignancies. Kidney transplant patients are also commonly associated with viral warts that might change into skin cancers. Objective: To re-evaluate all features of the acquired epidermodysplasia verruciformis in kidney transplant patients in comparison with healthy individuals. Patients and Methods: This case controlled study that included 100 patients with kidney transplantation(87 males, 13 females) their ages ranged from 14-70(46.65 ± 4.74) years and was done in kidney Transplantation Centers in Baghdad and Al-Karma Teaching Hospitals from June 2009-August 2010. Patients included were receiving multiple immunosuppressive drugs like azathioprine, prednisolone, cyclosporine, mycophenolate mofetil ranged from 6 months-25 years. One hundred healthy individuals (70 males, 30 females), there ages ranged from 14-73 (41.63 ± 9.55) years, had been examined as a control for the presence of viral warts and tumors. These control cases had been taken randomly from general population in multiple regions in Baghdad Results: Forty (40%) patients out of one hundred kidney transplant patients had viral warts and were seen in 9(9%) of control group and there was statistically significant difference between patients and control cases (P value < 0.00001). Most of the viral warts were multiple and of the verrucae vulgaris type and were mainly located on the exposed areas of the body, mostly on the face and dorsa of the hands. Solar keratosis admixed with viral warts were found in 14 out of 100 kidney transplant patients. Skin malignancies in these fourteenth patients were observed in 6 (42.14%) cases: 2 SCC and 4 basal cell carcinoma (BCC) and these were mainly located on the exposed areas of the body, mostly on the face and dorsa of the hands. No skin malignancies were observed in control group. Conclusions: Kidney transplant recipients had all the features that simulate the inherited Epidermodysplasia Verruciformis.
Cite this paper: K. Sharquie, A. Noaimi and A. A. Al-Jobori, "Re-Evaluation of Acquired Epidermodysplasia Verruciformis in Kidney Transplant Recipients," Journal of Cosmetics, Dermatological Sciences and Applications, Vol. 2 No. 3, 2012, pp. 174-178. doi: 10.4236/jcdsa.2012.23033.
References

[1]   J. C. Sterling and J. B. Kurtz, “Viral Infections,” In: R. H. Champion, J. L. Burton and D. A. Burn, Eds., Rook’s Textbook of Dermatology, Blackwell Science Ltd. Editorial Office, Oxford, 1998, pp. 995-1095.

[2]   N. Penneys, “Diseases Caused by Viruses,” In: D. Elder, R. Elenitsas, C. Jaworsky and B. Johnson Jr., Eds., Lever’s Histopathology of the Skin, W.B. Saunders Company, Philadelphia, 1997, pp. 569-589.

[3]   D. R. Lowy and E. J. Androphy, “Warts,” In: I. M. Freedberg, A. Z. Eisen, K. Wolff, K. F. Austen, L. A. Goldsmith and S. I. Katz, Eds., Fitzpatrick’s Dermatology in General Medicine, The McGraw-Hill Companies, New York City, 2003, pp. 2119-2131.

[4]   R. B. Odom, W. D. James and T. G. Berger, “Viral, Diseases,” In: Andrew’s Diseases of the Skin: Clinical Dermatology, W.B. Saunders Company, Philadelphia, 2000, pp. 473-525.

[5]   R. S. Ostrow, D. Manias, A. J. Mitchell, L. Stawowy and A. J. Faras, “Epidermodysplasia Verruciformis. A Case Associated with Primary Lymphatic Dysplasia, Depressed Cell-Mediated Immunity, and Bowen’s Disease Containing Human Papillomavirus 16 DNA,” Archives of Dermatology, Vol. 123, No. 11, 1987, pp. 1511-1516.

[6]   H. Pfister, “Human Papillomaviruse and Impaired Immunity vs Epidermodysplasia Veruciformis,” Archives of Dermatology, Vol. 123, No. 11, 1987, pp. 1469-1470. doi:10.1001/archderm.1987.01660350069015

[7]   M. Yutsudo, T. Tanigaki, R. Kanada, T. Sasagawa, T. Inoue, P. Jing, I. I. H. Yong and A. Hakura, “Involvement of the Human Papilloma Viruse Verruciformis Skin Carcinogenesis,” Journal of Clinical Microbiology, Vol. 32, No. 4, 1994, pp. 1076-1078.

[8]   S. Majewski, E. Skopinska-Rozewska, S. Jablonska, M. Wasik and J. Misiewicz, “Partial Defects of Cell-Mediated Immunity in Patients with Epidermodysplasia Verruciformis,” Journal of the American Academy of Dermatology, Vol. 15, No. 5, 1986, pp. 966-973. doi:10.1016/S0190-9622(86)70258-2

[9]   G. Orth, “Epidermodysplasia Verruaformis: A Model for Understanding the Oncogensity of Human Papilloma Viruses,” Ciba Foundation Symposium, Vol. 120, 1986, pp. 157-174.

[10]   K. E. Sharquie, S. A. Al-Mashhadani, A. A. Noaimi and M. Y. Abbas, “Acquired Epidermodysplasia Verruciformis in Kidney Transplant Patients,” Journal of the Saudi Society of Dermatology & Dermatologic Surgery, Vol. 15, No. 2, 2011, pp. 53-56.

[11]   D. Hamilton, “A Kidney Transplantation: A History,” In: P. J. Morris, Ed., Kidney Transplantation Principles and Practice, W.B. Saunders Company, Philadelphia, 1988, pp. 1-11.

[12]   G. Rowan, R. G. Walker and J. F. Antony, “A 2 Azthioprine and Steroids,” In: P. J. Morris, Ed., Kidney Transplantation, Principles and Practice, W.B. Saunders Company, Philadelphia, 1988, pp. 319-399.

[13]   R. Rudlinger, I. W. Smith, M. H. Bunney and J. A. Hunter, “13-Human Papilloma Virus Infections in a Group of Renal Transplant Recipients,” British Journal of Dermatology, Vol. 115, No. 6, 1986, pp. 681-692. doi:10.1111/j.1365-2133.1986.tb06649.x

[14]   I. M. Leigh and M. T. Glover, “Skin Cancer and Warts in Immuno Suppressed Renal Transplant Recipients,” Recent Results in Cancer Research, Vol. 139, 1995, pp. 69-86. doi:10.1007/978-3-642-78771-3_6

[15]   I. M. Leigh and M. T. Glover, “Cutaneous Warts and Tumors Inimmunosuppressed Patients,” Journal of the Royal Society of Medicine, Vol. 88, No. 2, 1995, pp. 61-62.

[16]   K. E. Sharquie and S. A. Al-Sadawi, “Cutaneous Manifestations in Renal Transplant Recipients among Iraqi Patients,” Iraqi Journal of Community Medicine, Vol. 14, No. 1, 2001, pp. 1-4.

[17]   K. Murao, Y. Kubo, K. Fukubara, K. Mastsumoto and S. Arape, “Three Cases of Bowen’s Disease on the Lower Abdomen with High Risk Types 16, 33 and 59 of HPVs,” Journal of the American Academy of Dermatology, Vol. 52, No. 4, 2004, pp. 723-724.

[18]   L. M. De Jong-Tieben, R. J. Berkhout, H. L. Smits, J. N. Bouwes Bavinck, B. J. Vermeer, F. J. van der Woude and J. ter Schegget, “High Frequency of Detection of Epidermodysplasia Verruciformis Associated Human Papilloma Viruses DNA Detection in Biopsies from Malignant and Pre Malignant Lesions from Renal Transplant Recipient,” Journal of Investigative Dermatology, Vol. 105, No. 3, 1995, pp. 367-371.

[19]   A. Annelies, A. Peter and B. Martina, “Skin Changes and Tumors after Renal Transplantation,” Clinical Issues in Nephrology, Vol. 91, No. 2, 2002, pp. 188-196. doi:10.1159/000058391

[20]   R. Jeffrey, L. Edgar and A. Reza, “Cutaneous Neoplasm in Renal Transplant Recipients,” European Journal of Dermatology, Vol. 12, No. 6, 2000, pp. 532-535.

[21]   V. Shamanin, M. Glover, C. Rausche, C. Proby, I. M. Leigh, H. zur-Hausan and E. M. de-Villiers, “Specific Types of Human Papillomavirus Found in Benign Proliferation and Carcinoma of the Skin in Immunosuppressed Patients,” Cancer Research, Vol. 54, No. 17, 1994, pp. 4610-4613.

[22]   J. Doorbar, “Specific Interaction between HPV-16 EI-E4 and Cytokeratins Results in Collapse of the Epithelial Cell Intermediate Filament Network,” Nature, Vol. 352, 1991, p. 824. doi:10.1038/352824a0

[23]   L. M. Tieben, R. J. Berkhout, H. L. Smits, et al., “Detection of Epidermodysplasis Verruciformis-Like Human Papilloma Virus Types in Malignant and Premalignant Skin Lesions of Renal Transplant Recipients,” British Journal of Dermatology, Vol. 131, No. 2, 1994, pp. 226-230.

[24]   I. Penn, “Cancers in Cyclosporine Treated vs Azathioprine Treated Patients,” Transplantation Proceedings, Vol. 28, No. 2, 1996, pp. 876-878.

[25]   A. E. Taylor and S. Shuster, “Skin Cancer after Renal Transplantation: The Causal Role of Azathioprine,” Acta Dermato-Venereologica, Vol. 72, No. 2, 1992, pp. 115-119.

[26]   C. M. Perrette, S. L. Walker, P. O’Donovan, J. Warwick, C. A. Harwood, P. Karran and J. M. McGregor, “Azathioprine Treatment Photosensitive Human Skin to Ultraviolet a Radiation,” British Journal of Dermatology, Vol. 159, No. 1, 2008, pp. 198-204. doi:10.1111/j.1365-2133.2008.08610.x

[27]   L. Peyrin-Biroulet, K. Khosrotehrani, F. Carrat, A. M. Bouvier, J. B. Chevaux, T. Smon, F. Carbonnel, J. F. Colombel, J. L. Dupas, P. Godeberege, J. P. Hugot, M. Lemann, S. Nahon, J. M. Sabate, G. Tucat, L. Beaugerie, Cesame Study Grpup, “Increased risk for nonmelanoma skin cancers in patients who receive Thiopurines for inflammatory bowel disease,” Gastroenterology, Vol. 141, No. 5, 2011, pp. 1621-1628.

[28]   K. E. Sharquie, A. A. Noaimi and S. Y. Mohsin, “Frequency of Autoimmune Diseases and Estimation of P53 among Vitiligo Patients,” Thesis for Fellowship of Iraqi Board for Medical Specializations in Dermatology and Venerevlogy, Iraqi Board for Medical Specializations, Baghdad, 2011.

 
 
Top