SEBACEOUS HYPERPLASIA IN ORGAN TRANSPLANT RECIPIENTS - SHARED ASPECTSOF HYPERPLASTIC AND DYSPLASTIC PROCESSES

Background: Patients receiving kidney or heart transplants are subject to a wide range of cutaneous changes attributed largely to the immuno suppression required to prevent rejection of their transplant. In addi tion to infection, they have an increased incidence of dysplastic lesi ons, some of which are malignant. Objective: Our purpose was to determ ine the incidence of sebaceous hyperplasia in heart and kidney transpl ant recipients and its association with neoplasia.Methods: Patients un dergoing heart transplantation from a single transplant center were ex amined during a 30-month screening period to establish the prevalence of cutaneous abnormalities. Results: Sixteen of 104 (16%) heart transp lant recipients had sebaceous hyperplasia in comparison with 1% of an age- and sex-matched control group. Those with sebaceous hyperplasia d id not have a significantly higher incidence of hypertrichosis than th ose without sebaceous hyperplasia. Conclusion: Sebaceous hyperplasia i s seen in heart transplant recipients. It does not appear to be connec ted with hypertrichosis, in which it is believed that the pilosebaceou s unit is the target of the direct effects of cyclosporine. We propose that the development of sebaceous hyperplasia is related to the proce ss of dysplastic epithelial proliferation in transplant recipients.