RESUMO

Solid organ transplant recipients (SOTRs) are susceptible to various cutaneous side effects as a consequence of long-term immunosuppressive therapy. Skin cancers and infections are well-studied complications that can cause death and/or allograft rejection. Other cutaneous drug reactions, such as inflammatory manifestations, have a high prevalence but are rarely studied. We analyzed these manifestations' prevalence and their association with immunosuppressants in transplant recipients from a Brazilian tertiary center. Among 532 SOTRs followed at our dermatology clinic, 60 (11.3%) developed some cutaneous adverse reactions to the immunosuppressants, with a median age at transplantation of 50.5 years and a median life span posttransplantation of seven years. Acneiform eruption was the most common drug reaction found (21 patients, 30.4%), followed by diffuse non-scarring alopecia (16 patients, 23.1%), lymphedema (10 patients, 14.5%), gingival hyperplasia (7 patients, 10.1%), hypertrichosis (6 patients, 8.7%) and sebaceous hyperplasia (9 patients, 13.1%). Adequate immunosuppression is an essential prerequisite for successful organ transplantation. In the immediate post-transplant period, significant immunosuppression is needed, but after that, the complications of excessive immunosuppression outweigh the risk of organ rejection. SORTs may present with a broad spectrum of inflammatory and cosmetic findings due to immunosuppressants that can impair life quality.

Assuntos

RESUMO

Describir la frecuencia de erupciones acneiformes y/o exacerbaciones de un acné previo tras una cirugía ortognática. La muestra consta de 57 pacientes (n=57) de ambos sexos, sometidos a una cirugía ortognática, los cuales fueron evaluados en: el preoperatorio (0-7 días previos); en distintas etapas de la cirugía; postoperatorio inmediato (7 ­ 15 días post cirugía) y postoperatorio mediato (30 ­ 40 días postquirúrgicos). En todos los controles clínicos mencionados se determinó la presencia/ausencia, ubicación, severidad y diagnóstico de las erupciones acneiformes. El 52,6 % de los pacientes sometidos a cirugía ortognática presentaron erupciones acneiformes, siendo mayores en las mujeres en comparación con los hombres. La severidad de las erupciones acneiformes es mayor en el postoperatorio inmediato en comparación al preoperatorio y postoperatorio mediato. La ubicación más frecuente del acné corresponde a la región frontal, tanto en el preoperatorio (22,8 %) como en el postoperatorio inmediato (31,6 %). En el postoperatorio mediato la zona más frecuente es la geniana (39 %). La frecuencia de acné post cirugía ortognática es elevada, siendo mayor en mujeres que en hombres. La severidad de este acné es mayor en el postoperatorio inmediato. La región frontal corresponde a la zona más frecuente de aparición de las erupciones acneiformes en el postoperatorio inmediato y la zona geniana en el postoperatorio mediato. El diagnóstico de estas erupciones acneiformes corresponde a un acné esteroidal, por lo que se puede sugerir un posible plan de tratamiento, con el fin de mejorar el postoperatorio de las pacientes y evitar, en lo posible, futuras manifestaciones en nuevas pacientes sometidas a este tipo de cirugía.

Describe the frequency of acneiform eruptions and / or exacerbations of a previous acne after orthognathic surgery. The sample consisted of 57 patients (n = 57) of both genders, undergoing orthognathic surgery, who were evaluated with a follow-up of 2 postoperative months, at different stages of surgery; Preoperative (0-7 days), immediate postoperative (7-15 days) and mediate postoperative (30-40 days). The presence / absence, location, severity and diagnosis of acneiform eruptions were determined in all clinical controls. The frequency of acneiform eruptions corresponds to 52.6 % of patients undergoing orthognathic surgery, being higher in women compared to men in relation to the presence of acneiform eruptions and / or exacerbations of a previous acne after the intervention. The severity of acneiform eruptions is greater in the immediate postoperative period compared to the preoperative and mediate postoperative period. The most frequent location to be found in the facial region is in the frontal area, both in the preoperative (22.8 %) and in the immediate postoperative period (31.6 %). In the postoperative period, the most frequent is the genial area (39 %). The appearance of acneiform eruptions corresponds to steroidal acne. The frequency of acne post orthognathic surgery is high, being higher in women than in men. The severity of this acne is greater in the immediate postoperative period. The frontal region corresponds to the most frequent area of onset of acneiform eruptions in the immediate postoperative period and the genial area in the postoperative period. The diagnosis of these acneiform eruptions corresponds to a steroidal acne, so it is possible to suggest a possible treatment plan, in order to improve the postoperative of the patients and to avoid, as far as possible, future manifestations in new patients undergoing this type of surgery.

Assuntos