Clinical Spectrum of Cutaneous Manifestations in Renal and Renopancreatic Recipients in Two Centers in Uruguay L. Dufrechou a, *, M. Nin b,c , L. Curi c , P. Larre Borges b,c , M. Martínez Asuaga a , O. Noboa b , S. Orihuela c , F. González-Martínez b,c , and A. Larre Borges a a Dermatology Department, Hospital de Clínicas “Dr. Manuel Quintela,” Montevideo, Uruguay; b Nephrology Department, Hospital de Clínicas “Dr. Manuel Quintela,” Montevideo, Uruguay; and c Instituto de Nefrología y Urología, Montevideo, Uruguay ABSTRACT Uruguay, with a total population of 3,345,000 inhabitants, is the Latin American country with the second highest number of renal replacement therapies. Long-term immunosup- pressant therapy is essential for graft survival but results in reduced immunosurveillance, leading to an increased risk of complications. A variety of dermatological manifestations and a large increase in nonmelanoma skin cancers have been reported in this population. The purpose of this study was to evaluate the frequency and clinical spectrum of cutaneous manifestations in renal and renopancreatic recipients in 2 reference centers in Uruguay. Two hundred and six renal or renopancreatic recipients between 21 and 77 years old were evaluated between September 2009 and September 2011. A total of 206 dermatoses were observed; 60% of the patients had at least 1 cutaneous manifestation. The most frequent dermatoses were cutaneous side effects due to immunosuppressive treatment (40.6%), followed by infections (26.1%), miscellaneous causes (18.9%), and malignant and pre- malignant lesions (14.4%). Transplant recipients represent a high-risk dermatological population. Physicians in transplant units should be aware of the importance of derma- tological screening in order to promote early detection of skin cancer. I N LATIN America, Uruguay is the second leading country, after Puerto Rico, in prevalence of renal replacement therapies, including hemodialysis, peritoneal dialysis, and functioning kidney allograft [1]. Since the first cadaveric kidney transplant in 1969, approximately 1803 renal and renopancreatic transplants have been performed in our country through December 2012 [2]. Transplant medicine has seen many innovations over the past decades, and continues to evolve. New strategies in immunosup- pressive therapy are associated with better patient and graft survival rates; however, the adverse toxicities and long-term side effects associated with these agents present a number of challenges. A variety of cutaneous complications as well as an in- crease in cutaneous malignancies have been reported in this population, particularly among Caucasians [3e6], having a great impact in the quality of life of many individuals [6,7]. The purpose of this study was to evaluate the clinical spectrum of cutaneous manifestations occurring in renal and renopancreatic recipients in 2 reference centers in Uruguay. PATIENTS AND METHODS Two hundred and six renal and renopancreatic recipients from 2 Uruguayan reference centers were included in this study between September 2009 and September 2011. Inclusion criteria were defined as patients who: 1) were renal or renopancreatic recipients from Hospital de Clínicas or Nephrology and Urology Institute of MontevideoeUruguay, 2) were age 18 years or older, 3) agreed to scheduled nephrology examination during the inclusion period, and 4) were referred for dermatological consultation when a lesion or an eruption was noted by the nephrologist. Exclusion criteria were to not meet the eligibility criteria. The dermatoses and lesions were divided into 4 groups: infections, premalignant and malignant lesions, adverse effects of immunosuppressive treatment, and miscellaneous causes. Lesions suspicious of malignancy underwent biopsy for histo- pathological confirmation. Data analysis was performed using SPSS version 15.0. *Address correspondence to Lídice Dufrechou, Avenida Italia s/n, 1  piso, Cátedra de Dermatología Montevideo, Uruguay. E-mail: ldufrechou@gmail.com ª 2014 by Elsevier Inc. All rights reserved. 360 Park Avenue South, New York, NY 10010-1710 0041-1345/14 http://dx.doi.org/10.1016/j.transproceed.2014.07.012 Transplantation Proceedings, 46, 3047e3049 (2014) 3047