Gn. King et al., INCREASED PREVALENCE OF DYSPLASTIC AND MALIGNANT LIP LESIONS IN RENAL-TRANSPLANT RECIPIENTS, The New England journal of medicine, 332(16), 1995, pp. 1052-1057
Background. Renal-transplant recipients are known to have increased ra
tes of skin cancer associated with exposure to the sun. Little is know
n, however, about the prevalence and histologic features of lesions of
the lips in these patients, or about risk factors for such lesions. M
ethods. We examined the lips of 160 renal-transplant recipients (105 m
en and 55 women; mean [+/-SD] age, 48+/-13 years) and 160 normal subje
cts matched with the transplant recipients for age, sex, and skin type
. The mean length of time between transplantation and the examination
was 69+/-52 months; 58 percent of the recipients had received their gr
afts more than 60 months earlier. Results. Among the 160 renal-transpl
ant recipients, 21 (13 percent) had leukoplakia; in 2 (1.2 percent) th
e leukoplakia contained squamous-cell carcinoma. In contrast, only one
normal subject (0.6 percent) had leukoplakia. Histologically, 13 of t
he 21 leukoplakias (62 percent) in the renal-transplant recipients who
underwent biopsy were dysplastic, and 2 (10 percent) contained squamo
us-cell carcinoma. Actinic change was evident in 91 percent of the dys
plastic lesions but not in the nondysplastic lesions (P<0.001). Exposu
re to the sun and smoking were risk factors for dysplastic and maligna
nt lip lesions in the renal-transplant recipients (P<0.001 and P=0.003
, respectively). Among these recipients, only men had dysplastic or ma
lignant lip lesions (P=0.006); lipstick was used frequently by 73 perc
ent of the women. The clinical appearance of lip lesions did not predi
ct the presence of dysplasia or cancer. Conclusions. Renal-transplant
recipients have an increased prevalence of leukoplakia, dysplasia, and
cancer of the lip.