LYMPHOCYTE SUBSETS AND LANGERHANS CELLS IN SUN-PROTECTED AND SUN-EXPOSED SKIN OF IMMUNOSUPPRESSED RENAL-ALLOGRAFT RECIPIENTS

Background: Patients who have received renal allografts experience ear ly aging of the skin, opportunistic infections, and an increased incid ence of skin cancer. Objective: We compared the density of lymphocyte subsets and Langerhans cells in normal-appearing skin of renal allogra ft recipients without skin cancer at 5 to 6 years (group 1) and 14 yea rs after transplant (group 2) with a matched normal control group, Met hods: Biopsy specimens of sun-protected and exposed areas from 18 whit e, kidney allograft recipients (10 in group 1 and 8 in group 2) with n ormal renal function and from 10 healthy volunteers were semiquantitat ively analyzed for dermal lymphocyte subsets and Langerhans cells. Res ults: There was a statistically significant decrease in all dermal cel l elements in the sun-protected skin of both groups of patients who ha d received grafts. The sun-exposed skin of group 2 also showed a signi ficant decrease of dermal CD4(+) and CD8(+) lymphocytes, and group 1 h ad a significant decrease in dermal CD8(+) lymphocytes. The dermal CD1 a(+) cell population in the sun-exposed skin from both grafted groups did not differ from the control group. Conclusion: Kidney transplant r ecipients showed dermal depletion of cells related to immune surveilla nce against tumors even before skin cancer occurred, and this depletio n seemed to become more marked with the duration of immunosuppression.