Prevention of skin complications from immunodepression in organ transplantation

As skin diseases after organ transplantation are often disabling and sometimes lethal, it is essential to develop preventive measures. The group "Skin and organ transplantation" of the French Society of Dermatology concentrated one's efforts on skin carcinomas and Kaposis's sarcoma. Skin carcinomas are the most frequent tumors observed in transplant recipients. Many factors participate to their pathogenesis such as genetic, environmental and iatrogenic. Their prevalence is very high in elderly transplant recipients with fair complexion, long time of immunosuppression, long time of sun exposure, multiple keratoses and warts. Preventive measures consist educational training, sun avoidance and treatment of keratoses. Transplant recipients who develop Kaposi's disease are all infected with Human Herpes Virus 8 (HHV-8). HHV-8 promoinfection occurred frequently before transplantation. Cofactors involved in the development of Kaposi' sarcoma will be probably identified by the results of an ongoing national prospective study of kidney transplant recipients. Immunosuppressive therapy should be tapered to the lowest possible level compatible with allograft function.