Epidermal dysplasia and cyclosporine therapy in renal transplant patients: a comparison with azathioprine.

The prevalence of dysplastic cutaneous lesions was determined in a group of 68 renal transplant patients whose immunosuppressive therapy included cyclosporine but not azathioprine. The mean age of the patients was 41 years (range 17-67), and the mean transplant time was 44 months (range 24-75). Dysplastic cutaneous lesions were found in 14 out of 68 patients, a prevalence of 20.6%. Although the lesions arose on sun-exposed sites, there was no apparent correlation with previous sun-exposure. The cumulative prevalence of dysplastic cutaneous lesions in 64 patients who had received cyclosporine for between 24 and 72 months was compared with 33 renal transplant patients who had been treated with azathioprine over a similar period of time. The overall prevalence of cutaneous dysplasia was 22% in the cyclosporine group and 9% in the azathioprine group. The cumulative prevalence of cutaneous dysplasia in the cyclosporine group was greater at all time points studied. In contrast to previous reports, we have found no evidence that the risk of cutaneous malignancy in patients treated with cyclosporine is less than that found in patients maintained on azathioprine.