INCREASED PREVALENCE OF DYSPLASTIC AND MALIGNANT LIP LESIONS IN RENAL-TRANSPLANT RECIPIENTS

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.