Publication:
Dermatological disease in heart and lung transplant recipients

dc.contributor.advisor Parsi, Kurosh en_US
dc.contributor.advisor Paddon, Vanessa en_US
dc.contributor.advisor Glanville, Allan en_US
dc.contributor.author De Rosa, Nicholas en_US
dc.date.accessioned 2022-03-15T12:10:50Z
dc.date.available 2022-03-15T12:10:50Z
dc.date.issued 2018 en_US
dc.description.abstract Introduction: Skin disease is common in immunosuppressed solid organ transplant recipients (SOTRs) and skin cancer, in particular, is a major cause of morbidity and mortality in these patients. This study aims to determine the rates and risk factors for skin cancer in Australian heart and lung transplant recipients (HLTRs). It also aims to examine the spectrum of skin diseases encountered in HLTRs and their effect on quality of life (QOL). Methods: Ninety-four participants were recruited from the Dermatology Outpatient Clinic at St. Vincent’s Hospital Sydney between March and December 2016. Retrospective skin cancer diagnoses were obtained from medical records and participants were also examined prospectively for malignant and non-malignant skin disease. A questionnaire and the Dermatology Life Quality Index were administered to all participants. The probabilities of developing non-melanoma skin cancer (NMSC), squamous cell carcinoma (SCC), and basal cell carcinoma (BCC) were estimated using Kaplan-Meier analysis. The association of risk factors with skin cancer development were examined using the Cox proportional hazards model. The association of examined variables with DLQI score were assessed using univariate and multivariate logistic regression analysis. Results: Retrospectively, there were 801 post-transplant skin cancers in 61% of participants. At 5 and 10 years post-transplantation the probabilities were 41% and 67% for developing NMSC, 27% and 53% for developing BCC, and 33% and 62% for developing SCC, respectively. A prospective dermatological diagnosis was made in 87% of the participants over the study period. Actinic keratosis was the most common diagnosis, affecting 53% of participants, followed by skin cancer in 44% and warts in 15% of participants. Other non-malignant skin diseases were less common. Risk factors significantly associated with skin cancer included older age at transplantation, history of pre-transplant skin cancer, and history of ≥5 post-transplant skin cancers. Fitzpatrick skin type 3-6 was associated with a decreased risk of NMSC. Skin disease had a negative effect on the QOL of a minority of HLTRs. The use of tacrolimus was associated with better QOL scores on multivariate analysis. Conclusion: Australian HLTRs have high rates of skin cancer that exceed the rates reported for other SOTRs. en_US
dc.identifier.uri http://hdl.handle.net/1959.4/61171
dc.language English
dc.language.iso EN en_US
dc.publisher UNSW, Sydney en_US
dc.rights CC BY-NC-ND 3.0 en_US
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/3.0/au/ en_US
dc.subject.other Heart transplant en_US
dc.subject.other Skin disease en_US
dc.subject.other Skin cancer en_US
dc.subject.other Lung transplant en_US
dc.subject.other Quality of life en_US
dc.title Dermatological disease in heart and lung transplant recipients en_US
dc.type Thesis en_US
dcterms.accessRights open access
dcterms.rightsHolder De Rosa, Nicholas
dspace.entity.type Publication en_US
unsw.accessRights.uri https://purl.org/coar/access_right/c_abf2
unsw.date.embargo 2020-02-01 en_US
unsw.description.embargoNote Embargoed until 2020-02-01
unsw.identifier.doi https://doi.org/10.26190/unsworks/3587
unsw.relation.faculty Medicine & Health
unsw.relation.originalPublicationAffiliation De Rosa, Nicholas, Clinical School - St Vincent's Hospital, Faculty of Medicine, UNSW en_US
unsw.relation.originalPublicationAffiliation Parsi, Kurosh, Clinical School - St Vincent's Hospital, Faculty of Medicine, UNSW en_US
unsw.relation.originalPublicationAffiliation Paddon, Vanessa, Clinical School - St Vincent's Hospital, Faculty of Medicine, UNSW en_US
unsw.relation.originalPublicationAffiliation Glanville, Allan, Clinical School - St Vincent's Hospital, Faculty of Medicine, UNSW en_US
unsw.relation.school Clinical School St Vincents Hospital *
unsw.thesis.degreetype Masters Thesis en_US
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