Background: Immunosuppression (IS) results in heightened risk of developing posttransplant cutaneous complications. Black solid organ transplant recipients (OTRs), who often receive higher doses of IS compared to whites, are also less likely to receive dermatologic screening posttransplant. Despite a growing population of nonwhite OTRs, there are limited data addressing racial differences in the prevalence of cutaneous disease after organ transplantation.

Objective: Compare rates of dermatologic disease between Black and white OTRs

Methods: Retrospective cohort study of adult OTRs evaluated in a single-center, medical-surgical transplant dermatology clinic. Patients from 11/1/11 to 3/1/17. Routine dermatologic screening was performed, by protocol, for all post-transplant patients regardless of race/ethnicity. All cutaneous diseases diagnosed after transplantation were documented.

Results: Among 372 OTRs, 207 (56%) were Black and 165 (44%) were white. Black OTRs were less likely to be male (55% vs 72%, p<0.01) and the average age for both races was 60. There was no significant difference in average follow-up time between Black and white OTRs (96mos vs 73mos; p=0.47). Compared to whites, Black OTRs were more likely to be diagnosed with benign growths (39% vs 16%, p<0.01), cutaneous fungal infections (25% vs 13%; p<0.01), acne/folliculitis (24.2% vs 3.6%; p<0.01), papulosquamous dermatoses (17.4% vs 6.1%, p<0.01), xerosis (15.0% vs 1.8%; p<0.01), cutaneous viral disease (15.9% vs 9.1%; p=0.05), pigmentary disorders (14.5% vs 1.2%; p<0.01), and autoimmune disease (4.8% vs 0.6%; p<0.01). Premalignant and cutaneous malignancies were less common among Black OTRs than white OTRs (4% vs 43%; p<0.01).

Conclusions: In our cohort, infectious and inflammatory cutaneous diseases were more prevalent among Black OTRs than white OTRs. Our study underscores the importance of increased awareness of racial differences in both referral patterns and the evaluation and diagnosis of skin disease in an increasingly diverse transplant population. We believe there is a need to screen patients of all skin types following transplant. Future studies are needed to determine modifiable risk factors for cutaneous disease in immunosuppressed nonwhite organ transplant recipients.

CITATION INFORMATION: Allawh R., Nadhan K., Doyle A., Harhay M., Chung C. Rates of Posttransplant Cutaneous Disease Differ between Black and White Solid Organ Transplant Recipients Am J Transplant. 2017;17 (suppl 3).

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