Seborrheic dermatitis among Oxford renal transplant recipients

Seborrheic dermatitis is an inflammatory dermatosis with a prevalence of 1-3% in the general population. It is recognized more commonly in those infected by human immunodeficiency virus (HIV). No studies have looked at Seborrheic dermatitis in the context of immunosuppression secondary to organ transplantation. Therefore, we investigated the prevalence of Seborrheic dermatitis in a renal transplant population and characteristics of those affected.

A prospective study of 308 renal transplant recipients (RTRs) was carried out. All participants were examined for Seborrheic dermatitis. Descriptive statistics were employed and associations with Seborrheic dermatitis were examined using Fisher's exact test to calculate P-exact values, and Student's t-test was used to compare mean ages and time since transplantation. Statistical analysis was carried out using SPSS version 14.0 for Windows.

Seborrheic dermatitis was identified in 29/308 (9.5%) patients and was more common in males (P-exact = 0.004) and in those who had been transplanted for longer (P = 0.02). The disease was mild-moderate severity in the majority but an unusual flexural appearance was recorded in 7/29 patients. Seborrheic dermatitis was less likely in those taking prednisolone (P-exact = 0.006) or tacrolimus (P-exact = 0.008). Seborrheic dermatitis was significantly associated with cutaneous malignancy, in particular squamous cell carcinoma (P-exact < 0.0001).

Seborrheic dermatitis is more common than other inflammatory dermatoses in immunosuppressed RTRs, but is not as frequent as in those immunosuppressed secondary to HIV. Degree and duration of exposure to immunosuppression and increased colonization with Malassezia yeast genus are likely be important in the aetiology of Seborrheic dermatitis in RTRs. Further studies are required to clarify this.