Histopathologic evaluation of Verrucous skin lesions in renal transplant recipients

Background: Warts are common in renal allograft recipients (RAR) with reported incidence of 24% to 100%. These patients also demonstrate an accelerated malignant transformation of warts. Although in immunocompetent patients, the histology of common warts is quite predictable, this is not so in RAR. Objective: The purpose of this study was to evaluate the histopathologic findings of warty lesions in RAR. Patients and Methods: We examined 55 RARs for warty lesions. We took biopsy specimens from lesions that clinically appeared to be common warts and evaluated their histopathologic features. Results: Among 55 RARs, 17 cases (30.9%) had warty lesions, and among 50 biopsied lesions, 47 lesions (94%) showed changes of verruca vulgaris and only 3 Lesions (6%) showed warts with dysplasia. No malignant transformation was reported. All patients were under treatment with prednisolone, cyclosporin and azathioprine. The median time passed from transplantation was 49 months. Conclusion: We couldn’t find evidence of dysplasia or malignancy in most verrucous lesions of RAR. This maybe due to relatively short time passed from transplantation in our patients.