فراواني ضايعات پوستي پس از پيوند كليه در بيماران مراجعه كننده به بيمارستان بقيه الله (عج)

Prevalence of skin lesions in patients after kidney transplantation referred to Baqiyatallah hospital

هدف از انجام اين مطالعه، تعيين فراواني ضايعات پوستي و بررسي ارتباط آن با مشخصات دموگرافيك بيماران پس از پيوند كليه بود. روش بررسي اين مطالعه به صورت مقطعي و بر روي100 بيمار مراجعه كننده به درمانگاه نفرولوژي بيمارستان بقيه الله (عج) كه طي سال 1394 (از فروردين ماه 1394 تا اسفند ماه سال 1394) تحت پيوند كليه قرار گرفته بودند انجام شد. اطلاعات بيماران در پرسش نامه هاي طراحي شده جمع آوري شده و مورد تجزيه و تحليل آماري قرار ﮔﺮﻓﺖ. ﯾﺎﻓﺘﻪ ﻫﺎ: ﻣﯿﺎﻧﮕﯿﻦ ﺳﻨﯽ ﺑﯿﻤﺎران ﻣﻮرد ﻣﻄﺎﻟﻌﻪ 50/4±11/82 ﺳﺎل ﺑﻮد. ﻣﯿﺎﻧﮕﯿﻦ ﻣﺪت زﻣـﺎن اﯾﺠـﺎد ﺿـﺎﯾﻌﻪ ﭘﻮﺳـﺘﯽ ﭘـﺲ از ﭘﯿﻮﻧﺪ 8/1±5/77 ﻫﻔﺘﻪ ﺑﻮد. ﺷﺎﯾﻊﺗﺮﯾﻦ ﻧﻮع ﺳﺮﻃﺎنﻫﺎي ﻏﯿـﺮ ﻣﻼﻧـﻮﻣﯽ، ﺳـﺎرﮐﻮم ﮐﺎﭘﻮﺳـﯽ )4%( و ﮐﺎرﺳـﯿﻨﻮم ﺳـﻠﻮلﻫﺎي ﺳﻨﮕﻔﺮﺷﯽ )2%( ﺑﻮد ﮐﻪ از ﻟﺤﺎظ آﻣﺎري ﺑﯿﻦ زن و ﻣﺮد ﺗﻔﺎوت ﻣﻌﻨﺎداري وﺟﻮد ﻧﺪاﺷـﺖ. )0/05>P(. ﻋﻔﻮﻧـﺖ ﭘﻮﺳـﺘﯽ در 66% اﻓﺮاد ﻣﺸﺎﻫﺪه ﺷﺪ ﮐﻪ ﺷﺎﯾﻊﺗﺮﯾﻦ آنﻫﺎ ﺑﻪﺗﺮﺗﯿﺐ زﮔﯿﻞ )34%( و ﺗﯿﻨﻪآ ورﺳﯿﮑﺎﻟﺮ )11%( ﺑﻮد. ﻣﯿﺰان اﺑﺘﻼ ﺑﻪ ﻋﻔﻮﻧﺖﻫﺎي ﭘﻮﺳﺘﯽ ﺑﻪﻃﻮر ﻣﻌﻨﺎداري در ﺑﯿﻤﺎران ﻣﺮد ﺑﺎﻻﺗﺮ از ﺑﯿﻤﺎران زن ﺑـﻮد )0/004=P(. ﻓﺮاواﻧـﯽ اﺑـﺘﻼ ﺑـﻪ ﻋﻔﻮﻧـﺖ ﭘﻮﺳـﺘﯽ ﺗﯿﻨـﻪ آ ﺳﯿﮑﺎﻟﺮ در اﻓﺮاد ﻣﺒﺘﻼ ﺑﻪ دﯾﺎﺑﺖ ﺑ ﻪ ﻃﻮر ﻣﻌﻨﺎداري ﺑﯿﺸﺘﺮ از اﻓﺮاد ﻏﯿﺮ دﯾﺎﺑﺘﯽ ﺑﻮد )0/046=P( در مجموع اين مطالعه نشان داد كه عوارض پوستي در بيماران پس از عمل پيوند كليه شايع است. آگاه كردن بيماران پيوند كليوي و كادر درمان از مسايل پوستي، منجر به ارجاع زود هنگام بيماران به متخصص مربوطه و كسب درمان هاي لازم شده و باعث افزايش طول عمر و بهبود كيفيت زندگي آن ها خواهد شد.

Immunosuppressive drugs that are widely used to prevent acute and chronic organ rejections, predispose organ transplant patients to a variety of diseases including skin problems. This study aimed to determine the prevalence of skin lesions and to investigate their association with demographic characteristics in renal transplant patients. Methods This cross-sectional study was performed on 100 patients who were referred to the nephrology clinic of Baqiyatallah Hospital, Tehran, Iran and underwent kidney transplantation within a year (from the first working day of the Iranian Hijri calendar in April 2015 until the last working day in March 2016). Patients were referred to a dermatologist in case of any skin lesions. Patients' data were collected in a researcher-made questionnaire and were analyzed using SPSS software, version 18. The p values less than 5% were considered to be significant. Results The mean and standard deviation (SD) of the patients' age was 50/4±11/8 years. The average time of incidence of skin lesion after transplantation has been 8/1 ± 5/7 weeks. The most common types of non-melanoma cancers were squamous cell carcinoma (2%) and Kaposi's sarcoma (4%) and there was no significant difference between men and women (p>0.05). Sixty-six percent of the patients had skin infections and the most common skin infections were wart (34%) and tinea versicolor (11%). The relative frequency of skin infections was significantly higher in male patients than in females (p=0.004). Considering all other confounding variables including smoking, hypertension, diabetes and other infectious diseases, the only noteworthy finding was the higher relative frequency of tinea versicolor in diabetic compared with non-diabetic patients (p=0.046). Conclusion This study showed that skin complications including various neoplastic (Sarcoma and Carcinoma), infectious (fungal and viral), and other (Acne and Hypertrichosis) diseases are common in patients with kidney transplantation who are taking immunosuppressive drugs. Informing these patients and medical staff about skin problems leads to an early referral of patients and increases their life expectancy and improves their quality of life.