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Genital Lesions in Organ Transplant Recipients
What types of genital lesions are found in organ transplant recipients and at what frequency? A study recently published in JAMA Dermatology assessed the prevalence and types of genital lesions observed in organ transplant recipients.
Squamous cell carcinoma is the most common skin cancer diagnosed in solid organ transplant recipients and confers significant mortality. The development of squamous cell carcinoma in the genital region is elevated in non-white organ transplant recipients. Viral induction, specifically human papillomavirus, is hypothesised to play a role in the pathophysiology of these lesions.
Among 496 organ transplant recipients included in the study, 111 of 120 recipients denied the presence of genital lesions but 53 of 120 were found to have genital lesions on physical examination.
Cutaneous malignant tumours (basal cell carcinoma and squamous cell carcinoma in situ) were found in six organ transplant recipients. Genital squamous cell carcinoma in situ was found in three, and condyloma was found in 29 recipients.
High rates of condyloma acuminata and cutaneous genital malignant tumours were found disproportionately in non-white organ transplant recipients, and high-risk human papillomavirus subtypes were associated with the development of genital squamous cell carcinoma in transplant recipients.
The study extrapolated that genital lesions in organ transplant recipients are common, but awareness is low. The authors recommended that all organ transplant recipients should undergo thorough inspection of genital skin as a part of routine post-transplant skin examinations.
Further, patients with darker skin types are disproportionately affected by cutaneous genital malignant tumours and should undergo a targeted program of early detection, prevention, and awareness focused on the risk of genital skin cancer after transplant. High-risk HPV subtypes are associated with genital squamous cell carcinoma in organ transplant recipients.
Nadhan KS, Larijani M, Abbott J, Doyle AM, Linfante AW, Chung CL. Prevalence and Types of Genital Lesions in Organ Transplant Recipients. JAMA Dermatol. 2018;154(3):323–329. doi:10.1001/jamadermatol.2017.5801
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