Incidence of betapapillomaviruses in the tumour and perilesional healthy skin in patients with basal cell carcinoma depending on sex, age, hair colour, tumour subtype, its location and dissemination.

INTRODUCTION: Basal cell carcinoma (BCC) is the most common skin cancer in the Caucasian population. It is believed that infections caused by viruses from the genus betapapillomavirus (ß-HPV) might be associated with the risk of BCC, but the spread of data on the prevalence of the virus in biopsies is significant. AIM: To assess the presence and diversity of ß-HPV in skin samples taken from the tumour and a fragment of healthy skin from the patients with BCC, as well as checking the correlation of factors listed below and presence of ß-HPV infection in the studied patients. MATERIAL AND METHODS: The study was conducted on the skin biopsies from 73 patients with histopathologically confirmed BCC. The following data were collected from patients: sex, age, hair colour and tumour location. Using the polymerase chain reaction (PCR) test, the presence of ß-HPV infection was detected in the tested samples. PCR and reverse hybridization assay were also used to genotype 25 types of ß-HPV. RESULTS: A statistically significant correlation was found between the sex and BCC type, BCC type and tumour location, BCC type and exposure to UV radiation, as well as between the hair colour and tumour location. The correlation between the BCC type and the number of tumours and HPV types detected was also noted. CONCLUSIONS: Preliminary studies suggest that one of the risk factors for development of infiltrating lesions is the presence of a single HPV 93 infection, but further research is needed to confirm these assumptions.

Comparison and evaluation of three different molecular methods for detection of human Betapapillomaviruses in skin biopsies from patients with nonmelanoma skin cancer and precancerous lesions.

Betapapillomaviruses have been linked to the development of nonmelanoma skin cancers. A great diversity of these viruses in skin specimens requires the use of sensitive and reliable detection methods. There are currently no standardized assays for diagnostic purposes. A combination of several molecular methods has great practical significance and gives the opportunity to broaden the spectrum of detected Beta-HPV types. In the present study, different molecular methods for Beta-HPVs detection and genotyping were used: PCRs with different sets of primers, PCR followed by reverse hybridization and direct sequencing of PCR amplimers; all performed in skin biopsies from lesions and perilesional healthy area of 118 patients with NMSC or precancerous lesions. Beta-HPVs were detected in 41% of 261 biopsies examined. The RHA for 25 types of Beta-HPVs showed a significantly higher sensitivity than PCR-based methods and allowed to detect 172 genotypes in 86 samples, including 39 with multiple infections. The most frequently identified types were HPV23, HPV24 and HPV93. HPV5 and HPV8, considered high-risk carcinogen types, were detected only in a small percentage of samples. Direct sequencing confirmed the presence of Beta-HPV genotypes from outside of RHA panel in the analysed biopsies. This allowed detecting thirty-two additional genotypes in 5 samples, that were positive only in RHA with the universal probe, which failed to identify the virus genotypes. Our findings confirmed the need to apply different methods to detect Beta-HPV infections.

Bacillary Angiomatosis in Renal Transplant Recipient: A Case Report.

INTRODUCTION: Bacillary angiomatosis (BA) is a rare, opportunistic infectious disease caused by the aerobic Gram-negative bacilli Bartonella henselae or Bartonella quintana. The main reservoir for those microbes are cats. The disease mostly affects immunocompromised patients with human immunodeficiency virus infection, after organ transplantation, undergoing corticosteroid and methotrexate therapy or with oncological history. CASE REPORT: We represent the case of a 65-year-old man who reported to the Department of Dermatology with a high fever and numerous nodular skin lesions on the 5th month of kidney transplantation. At that time, his immunosuppressive therapy consisted of tacrolimus 6 mg/day, mycophenolate mofetil 2 g/day, and prednisone 5 mg/day. Laboratory tests revealed an increased leukocyte count and elevated values of acute-phase proteins, but blood cultures were negative. Skin biopsy was performed and BA was diagnosed. The patient was given oral doxycycline 100 mg twice a day. During antibiotic therapy, his body temperature normalized and skin lesions began to resolve. The patient continued the above treatment for the next 3 months with good tolerance, and no relapse occurred in 1 year. CONCLUSION: BA should be listed among possible opportunistic infections in organ transplant recipients.

Comparison of Kidney Transplant Function, Lipid Metabolism Disorders, and Glucose and Hemoglobin Concentration in Transplant Patients Treated With Proliferation Signal Inhibitor (Everolimus) or Calcineurin Inhibitor (Tacrolimus).

INTRODUCTION: After kidney transplantation (KTx) in patients with diagnosed cancers, calcineurin inhibitor tacrolimus (TAC) is replaced by sirolimus or everolimus (EV). OBJECTIVE: The objective of the study was to compare the lipid metabolism parameters, KTx function, and glucose and hemoglobin (Hgb) levels in patients treated with EV to those on TAC. MATERIAL AND METHODS: The retrospective study included 114 patients: 54 (17 women and 37 men) aged 57.6 years (18-77 years) treated with EV and 60 (18 women and 42 men) aged 49.6 years (20-77 years) treated with TAC as a control group. Their total cholesterol (TC), triglycerides (TG), fasting glucose (FG), serum creatinine (SCr), Hgb, and estimated glomerular filtration rate (eGFR) were assessed. In the patients treated with EV, the above values were evaluated before conversion, as well as 12 and 24 months following the switch and were evaluated once in the group treated with TAC. RESULTS: In the EV-treated group, the mean preconversion values after 12 and 24 months were as follows: TC 5.06, 6.59, and 5.98 mmol/L; TG 1.90, 2.48, and 2.20 mmol/L; FG 94.95, 97.85, and 104.05 mg/dL; SCr 1.46, 1.44, and 1.56 mg/dL; Hgb 12.46, 12.83, and 13.36 g/dL; and eGFR 50.3, 50.6, and 50.5 mL/min/1.73 m2. In the patients on TAC, the authors obtained the following values: TC 4.6 mmol/L; TG 1.87 mmol/L; glucose 104.13 mg/dL; SCr 1.51 mg/dL; Hgb 13.96 g/dL; and eGFR 56.6 mL/min/1.73 m2. CONCLUSIONS: After conversion from TAC to EV, increased values of TC and TG were observed after 1 year, while the increased values of TC, TG, SCr, Hgb, and FG were observed after 2 years.

Post-transplant Lymphoproliferative Disorder in a Patient After Kidney Transplant, 5-Year Follow-up: A Case Report.

INTRODUCTION: Post-transplant lymphoproliferative disorder (PTLD) is a serious, life-threatening complication in organ transplant patients receiving immunosuppressive therapy. The risk factors include Epstein-Barr virus infection and a cumulative dose of the immunosuppression. CASE REPORT: We present a 5-year follow-up case of a 28-year-old patient with PTLD in the gastrointestinal tract. In the ninth month after kidney transplant, the patient was hospitalized for pain in the abdomen and diarrhea. Physical examination demonstrated tenderness in the area of the cecum, and colonoscopy revealed ulcerations in the large intestine. Polymorphic lymphoma (PTLD) was found in the collected samples. The patient received monotherapy treatment with anti-CD20 antibodies, resulting in complete remission of disease, confirmed by computed tomography scan and colonoscopy. CONCLUSION: PTLD may have a different clinical course and should be considered in the differential diagnosis of patients after organ transplant.

Level of inflammatory cytokines tumour necrosis factor α, interleukins 12, 23 and 17 in patients with psoriasis in the context of metabolic syndrome.

INTRODUCTION: Psoriasis is a chronic inflammatory skin disease with immunologic etiology. AIM: To investigate the levels of the proinflammatory cytokines tumor necrosis factor α (TNF-α), interleukin 23 (IL-23) and IL-17 in patients with psoriasis and psoriatic arthritis with concomitant metabolic syndrome. MATERIAL AND METHODS: This study included 60 patients with severe psoriasis. RESULTS: In patients with arterial hypertension concomitant with psoriasis, no statistically significant differences in cytokine levels were observed. On the other hand, in the group of patients diagnosed with diabetes, an increased level of IL-17 was observed. In patients with lipid disorders, the results were similar to the results of patients with diabetes. CONCLUSIONS: It is very important to study immunologic mechanisms responsible for the presence and severity of psoriasis, in order to personalize the therapy in the future and optimize the effect of action on the basic disease and on concomitant disorders.

Development of sampling method and chromatographic analysis of volatile organic compounds emitted from human skin.

AIM: The studies on volatile organic compounds emitted from skin are an interest for chemists, biologists and physicians due to their role in development of different scientific areas, including medical diagnostics, forensic medicine and the perfume design. This paper presents a proposal of two sampling methods applied to skin odor collection: the first one uses a bag of cellulose film, the second one, using cellulose sachets filled with active carbon. MATERIALS & METHODS: Volatile organic compounds were adsorbed on carbon sorbent, removed via thermal desorption and analyzed using gas chromatograph with mass spectrometer. RESULTS: The first sampling method allowed identification of more compounds (52) comparing to the second one (30). Quantitative analyses for acetone, butanal, pentanal and hexanal were done. CONCLUSION: The skin odor sampling method using a bag of cellulose film, allowed the identification of many more compounds when compared with the method using a sachet filled with active carbon.

Comparison of the incidence of skin cancers in patients on dialysis and after kidney transplantation.

INTRODUCTION: Kidney transplant (KTx) patients on immunosuppressive therapy are predisposed to the development of infections and cancers. AIM: To compare the incidence and type of malignant skin lesions in kidney transplant patients and the dialyzed population based on the initiated dermatologic screening. MATERIAL AND METHODS: The study included 598 patients: 486 kidney transplant recipients and 112 patients on maintenance dialysis. All the patients underwent dermatological examination. Only histologically confirmed cancers were included in this study. Age, gender and immunosuppressive therapy administration were also considered. Patients were followed up by a dermatologist for a period of 5 years. RESULTS: Fifty-eight skin cancers; 39 basal cell carcinomas (BCC), 13 squamous cell carcinomas (SCC), 1 Bowen disease, 2 Kaposi sarcoma, 1 malignant melanoma, 1 Merkel cell carcinoma, and 1 fibrosarcoma protuberans were diagnosed in 30 (6.2%) kidney transplant patients, and 8 lesions (7 BCC and 1 SCC) were found in 4 (3.6%) patients on dialysis. CONCLUSIONS: The initiated dermatologic screening program indicates that the risk of skin cancer incidence in post kidney transplant patients receiving immunosuppressive therapy was significantly higher than in patients on dialysis.

Clinical study on single-organ cutaneous small vessels vasculitis (SoCSVV).

Leukocytoclastic vasculitis (LCV) is a heterogenous group of disorders that may manifest as a mild disease isolated to the skin or be a part of life-threatening systemic vasculitis. According to the 2012 Chapel Hill Consensus Conference nomenclature, patients presenting symptoms of LCV confined only to the skin should be defined as suffering from a single-organ cutaneous small vessel vasculitis (SoCSVV). SoCSVV is a benign disease with a good clinical outcome but with a significant risk of relapse and skin ulcer formation.The aim of the current study was to characterize SoCSVV and to identify factors that may be associated with the risk of recurrence and skin ulcers.Medical records of patients with LCV hospitalized at the Department of Dermatology at University Hospital in Cracow in the years 2010 to 2015 were analyzed.A total of 24 patients fulfilled criteria of SoCSVV. Drugs and preceding infections were identified as precipitating factors in 40% and 20% of cases, respectively. Skin lesions other than palpable purpura (i.e., macules, urticarial vasculitis, or ulcers) were identified in almost half of the patients. Interestingly, the presence of macules independently increased the risk of skin ulcer formation (odds ratio = 16; 95% confidence interval: 1.5-176.6; P = 0.0075) in the multivariate logistic regression analysis. One-quarter of patients with SoCSVV experienced relapse during the 6-month follow-up. The greater number of affected skin areas was an independent risk factor of recurrence (odds ratio = 5; 95% confidence interval: 2-45; P = 0.02).SoCSVV was usually associated with drugs and preceding infections. The disease relapses in approximately one-quarter of the patients. The more severe the skin involvement in the course of SoCSVV, the higher is the risk of recurrence.

Primary cutaneous lymphomas: the analysis of cases treated in the Department of Dermatology University Hospital in Krakow.

Introduction: Primary cutaneous lymphomas are lymphoproliferative skin infiltrates of T-, B- or NK-cells, classified according to the World Health Organization - European Organization of the Research and Treatment of Cancer (WHO-EORTC) criteria. They are the second most common group of extranodal non-Hodgkin lymphomas, that present in the skin with no evidence of systemic involvement at the time of diagnosis. Aims: The aim of the study was the analysis of clinical profile of cutaneous lymphomas in the tertiary referral center in Poland. Material and Methods: We analyzed case records of 63 patients (26 women, 37 men aged 19 - 86) referred to the Department of Dermatology, University Hospital in Cracow for the diagnosis and treatment of cutaneous lymphoma. Results: After analysis of clinical and histological data, the final diagnoses were: mycosis fungoides (42 patients), primary cutaneous CD30+ lymphoproliferative disorder (7), Sezary syndrome (3), parapsoriasis (3), primary cutaneous B-cell lymphoma (1), acute myeloid leukemia (1), Hodgkin lymphoma coexistent with mycosis fungoides (1), generalized allergic contact dermatitis (2) and erythema elevatum diutinum (1). We excluded 2 patients due to incomplete data. The most common location of skin lesions was the lower limb (52.46%) and most common clinical presentation was raised erythematous lesion (26.23%). Pruritus was present in 45.9% of the patients and 39.3% had extracutaneous symptoms, with lymphadenopathy as the most common symptom. 37.7% of patients presented with mild eosinophilia and another 37.7% with mild monocytosis. Prior to referral to our center, general practitioners misdiagnosed the lymphomas commonly as: atopic and contact dermatitis, borreliosis, drug-induced exanthema. Conclusions: The diagnosis of cutaneous lymphoma is often delayed due to their indolent, often recurring course, non-specific symptoms and uncommon appearance. The cooperation of a clinician and pathologist is essential in the diagnostic process.

Autoimmunogenicity during anti-TNF therapy in patients with psoriasis and psoriatic arthritis.

INTRODUCTION: The tumor necrosis factor (TNF-α) was initially described as lymphotoxin or cachectin. The discovery of therapies blocking the action of TNF-α, in 1988, started a new era in the therapy. One of often reported adverse effects related to the use of TNF-α antagonists is induction of the formation of autologous antibodies and antibodies neutralizing anti-TNF drugs. The development of anti-TNF-induced lupus or classical drug-induced lupus is more rarely reported. AIM: To evaluate the presence and the level of anti-nuclear antibodies in patients with psoriasis and psoriatic arthritis and the influence of anti-TNF therapy used on the concentration of antinuclear antibody (ANA). MATERIAL AND METHODS: A total of 28 subjects were included in the study. 71.4% of subjects were diagnosed with psoriatic arthritis and 28.6% with plaque psoriasis. RESULTS: Among the patients with plaque psoriasis, the antinuclear antibodies were found in 25% of subjects and in 80% of patients with psoriatic arthritis. After the treatment an increase in the titer or appearance of antibodies was found in 66.7% in the infliximab group, 18.2% in the etanercept group and 54.7% in the adalimumab group. No subjects developed symptoms of drug-induced systemic lupus. CONCLUSIONS: Our findings have shown that all anti-TNF therapies induced ANA in psoriatic arthritis and psoriatic patients. Considering a mild course of lupus induced by anti-TNF treatment and, usually intrinsic, resolution of symptoms, the biological therapy still appears as a safe treatment for patients.

[Merkel cell carcinoma in patient after organ transplantation]. / Rak z komórek Merkla u chorych po transplantacji narzadów.

Merkel cell carcinoma (MCC) is a rare, neuroendocrine tumour of the skin characterized by a very aggressive course. Firm, red-to-purple, typically non tender papules or nodules is a common of it's clinical manifestation. This carcinoma is more common among white Caucasians males in advanced age. The important risk factors for MCC are immunodeficiency or immunosuppression in patients after organ transplantation. MCC observed in organ recipients is associated with especially rapid progression as compared with general population and tendency to metastasis. Surgical excision of primary tumour with adequate margins and sentinel lymph node dissection with adjuvant radiotherapy improves regional control of disease and patients survival. Chemotherapy is usually used as a palliative treatment for advanced forms of the disease.

[Risk factors of non melanoma skin cancers in kidney transplant patients]. / Czynniki ryzyka rozwoju nieczerniakowych raków skóry u chorych po przeszczepieniu nerki.

UNLABELLED: Non melanoma skin cancers (NMSC) represent a major challenge within the ever growing group of different organs recipients. The aim of the study was to evaluate risk factors influencing on frequency appearance of NMSC in patients after kidney transplantation. The clinical dermatological examination was performed in 486 patients after kidney transplantation consisted of 296 man (60.9%) and 190 woman (30.1%) in the mean age 46.1 +/- 13.1 (18-74 years) with median time after transplantation 74.3 +/- 52.1 months. Most of them (80.7%) before transplantation were treated by maintenance hemodialysis. Patients after kidney transplantation were checked by dermatologist for all skin abnormalities based on iniciated skin cancers screening program. All discovered abnormalities were described, their type, size, localization and results of histopathological examination were collected. The obtained results were analyzed based on t-Student's, Mann-Whitney's, chi-square and Fisher tests. Out of 486 studied patients, 53 NMSC were diagnosed in 25 kidney recipients including 39 basal cell carcinoma (BCC), 13 squamous cell carcinoma (SCC) and 1 Bowen's disease. The proportion of BCC to SCC was 2.79. NMSC occurred more often on sun skin exposure area, especially on the face. Almost all (96.2%) of the cancers were diagnosed in patients older than 50 years of age. Patients with NMSC comparing with those without were significantly older (52.8 +/- 7.8 vs. 41.0 +/- 7.8; p < 0.0001), have longer post-transplant period and have more frequent positive anamnesis of this cancer. There was no significant relationship between NMSC appearance and sex, cause of kidney failure, HLA mismatch, blood group as well as Rh factor. CONCLUSIONS: Older age of patients while transplantation, longer time of immunosuppressive therapy and previous NMSC are independent predictors of new skin cancers appearance.

Location of nonmelanoma skin cancers in patients after kidney transplantation.

INTRODUCTION: Long -term use of immunosuppressant therapy makes kidney transplant recipients particularly susceptible to infections and skin cancers. OBJECTIVES: The aim of the study was to evaluate the type and location of nonmelanoma skin cancers (NMSCs) in patients after kidney transplantation. PATIENTS AND METHODS: The study included 486 patients (296 men and 190 women; mean age, 46.1 ±13.1 years) after deceased -donor kidney transplantation, most of whom received triple immunosuppressive therapy. Patients underwent skin examination. All suspicious lesions were thoroughly described in terms of their type, size, and location. Only patients with histologically confirmed malignancy were included in the study. RESULTS: Of all 486 patients, 25 were diagnosed with 53 NMSCs, including 39 basal cell carcinomas, 13 squamous cell carcinomas, and 1 case of Bowen's disease. The lesions were observed on the face (n = 34), upper limb (n = 8), neck (n = 6), and trunk (n = 5). CONCLUSIONS: Most NMSCs were located on the sun -exposed areas, emphasizing the effect of ultraviolet radiation on the pathogenesis of skin cancers. The presence of lesions on the skin that had not been exposed to the sun indicates that a physical examination of the entire skin is necessary.

Cutaneous viral infections in patients after kidney transplantation: risk factors.

INTRODUCTION:  Infectious skin lesions are a common complication in renal transplant patients receiving immunosuppressive therapy. OBJECTIVES:  The aim of this study was to assess the prevalence and factors contributing to the development of viral skin infections in kidney transplant patients. PATIENTS AND METHODS:  The study included 486 patients, 296 men (60.9%) and 190 women (39.1%), aged 46.1 ±13.1 years, 74.3 ±52.1 months post­transplantation, who remained mostly on triple immunosuppressive therapy. All skin lesions detected during the dermatological examination were described in detail, and the type, size, exact location, dependence on age, sex, and the used immunosuppressive therapy were established. Patients were followed for 5 years. RESULTS:  Infectious skin lesions of viral origin were diagnosed in 189 of 486 patients (38.9%). The most frequent infections were viral warts (38.5%), which were more common in older patients (47.6 vs. 45.0 years, P <0.033). Viral warts were observed more often in men (P <0.031). Lesions of viral origin occurred more often in patients treated with immunosuppressive drugs for a longer period of time (53 vs. 37 months; P <0.021) and those who received azathioprine and cyclosporine A (P <0.001). In a multivariate logistic regression analysis, therapy with azathioprine was the only factor associated with increased risk of these complications (P <0.007). CONCLUSIONS:  Older age, male sex, and longer duration of immunosuppressive therapy affect the incidence of infectious skin lesions in patients after kidney transplantation. Treatment with cyclosporine A and azathioprine promotes the development of infectious viral warts.

[Factors influencing on the prevalence frequency of infectious skin changes of bacterial and fungal origin in patients after kidney transplantation]. / Czynniki wplywajace na czestosc wystepowania infekcyjnych zmian skórnych o etiologii bakteryjnej i grzybiczej u chorych po przeszczepieniu nerki.

UNLABELLED: Infective skin changes are frequent complications in patients after kidney transplantation receiving immunosuppressive therapy. The aim of the study was to evaluate factors influencing on frequency and type of skin infections of bacterial and fungal origin in patients after kidney transplantation. The study was performed in 486 patients, 296 male (60.9%) and 190 female (39.1%) aged 46.1 +/- 13.1 years (18-74 years) 74.3 +/- 52.1 months after kidney transplantation remain mainly on triple immunosupresive therapy. Type, size and localization of skin changes revealed during dermatological evaluation were described according age, sex, and applied immunosuppression. The obtained results were analyzed based on t-Student's, Mann-Whitney's, chi-square and Fisher tests. It was shown that fungal infective skin changes in patients after kidney transplantation are more frequent in older population (48.4 +/- 11.8 vs. 45.2 +/- 13.4 years; p < 0.017). The significant differences concern interdigitale mycoses 49.7 +/- 11.1 vs. 45.4 +/- 13.3 years; p < 0.009, nail mycoses 51.5 +/- 10.4 vs. 45.5 +/- 13.2 years; p < 0,004 and foot mycoses 51.8 +/- 10.7 vs. 45.5 +/- 13.2 years; p < 0.0005. In male more frequent as compare with female were also fungal infections (30.7% vs. 18.4%; p < 0.002) including pityriasis versicolor 37.0% vs. 9.5%; p < 0.016 and interdigitale mycoses 18.6% vs. 9.0%; p < 0.004. CONCLUSIONS: Infective skin changes frequency in patients after kidney transplantation on immunosuppressive therapy depends on advanced age, male sex, and applied immunosuppressive therapy.

[Comparison of the prevalence frequency of infectious skin changes in dialyzed patients and after kidney transplantation]. / Porównanie czestosci wystepowania infekcyjnych zmian skórnych u chorych leczonych dializami oraz przeszczepieniem nerki.

UNLABELLED: Due to graft preserving immunosuppressive therapy, renal transplant recipients are predisposed to the development of a variety of skin infections and skin cancers. The aim of the study was to compare prevalence frequency of infective skin changes among patients after kidney transplantation and the dialyzed population. Clinical dermatological examination was performed in 486 patients after renal transplantation. The group consisted of 296 men (60.9%) and 190 women (30.1%), of mean age 46.1+/-13.1 (18-74 years) with median time after transplantation of 74.3+/-52.1 months. Most of the patients (80.7%) before transplantation were treated by maintenance hemodialysis. The most frequent immunosuppression regiments were combination of cyclosporine A (CsA) with mycofenolate mofetil (MMF) and steroids (GKS)-207 patients (42.5%); tacrolimus (TAC) with MMF and GKS-102 (20.9%) and CsA with azathiopine and GKS-53 patients (10.9%). The group of 112 dialyzed patients consisted of: 57 males (50.9%) and 55 females (49.1%), aged 57.4+/-15.4 years without history of immunosuppressive therapy and were on maintenance dialysis for 63.2+/-74.0 months. Most of this group (77.7%) was on maintenance hemodialysis, while the remaining 22.3% on peritoneal dialysis. The obtained results were analyzed based on t-Student's, Mann-Whitney's, chi-square and Fisher tests. It was shown that infective skin changes were significantly more frequent in the group of patients after kidney transplantation as compared with the dialyzed population. They were observed in 53.9% and 9.8% of the studied populations, respectively (p<0.0001). In the studied group after kidney transplantation the most frequent were viral changes (38.9%). Fungal infection was observed in 25.9% of these patients, while bacterial in 1.2% of this study group. In the dialyzed population fungal infections were diagnosed in 8.9%, while viral in 3.6% of patients. No bacterial changes were observed in this group. Acne was observed in 16.5% of patients after kidney transplantation. CONCLUSIONS: 1. In the group of patients after kidney transplantation receiving immunosuppressive therapy viral, fungal and bacterial infective skin changes were significantly more frequent as compared with the dialyzed patients. 2. The most frequent skin changes observed in patients after kidney transplantation were viral warts.

[Kaposi's sarkoma in solid organ recipients]. / Miesak Kaposiego u biorców przeszczepów narzadów litych.

Kaposi's sarkoma (KS) is a malignancy with hyperplastic angio-proliferative lesions with inflammatory changes usually associated with human Herpesvirus 8 (HHV-8) infection. The predominant is skin localization with dark-blue or purplish colour nodules and plaques. Cutaneous changes may be associated with visceral involvement, which as a isolated form is rare. KS is not frequent disease in general population however risk of its development is substantially increased in immunocompromised patients including AIDS or receiving immunosuppression transplant organ recipients. The potency of immunosuppression is a highly relevant factor in the development of KS after transplantation. Patients receiving more intense immunosuppression are at a significantly higher risk of developing post transplant KS. Localized disease may be treated by surgery, kriotherapy or radiotherapy while widespread envolvement usually needs systemic therapy. Reduction or cessation of immunosuppression, especially calcineurin inhibitors, in transplant organs recipients gives positive therapeutic results. Swich from calcineurin inhibitors to rapamycin, immunosuppressive agent with anti-neoplastic activity, is a novel therapeutic option for solid rorgans recipients.