Subcutaneous nodules and infectious complications in renal allograft recipients

Renal transplant recipients are at increased risk of infectious diseases and subject to cutaneous infections because of the effects of immunosuppressive therapy. Some long-term descriptive follow-up studies confirm that skin infections are common among renal transplant recipients. We report the development of subcutaneous nodules among patients receiving renal transplantations from 1991 to 2009. Transplant recipients were followed by the Nephrology Unit at control visits according to the American Society Nephrology guidelines. Between 1991 to 2009, subcutaneous nodules were identified in 7 out of 774 renal transplant recipients. The male:female ratio was 5:2; median age at renal transplantation was 52 years (range 28-59). Subcutaneous nodules were identified at a median 3 years after transplantation. The 7 patients had the following diagnoses: systemic scedosporiasis (n = 1); Mycobacterium avium complex infection (n = 2) disseminated tuberculosis (n = 2) Sporothrix schenckii infection (n = 1); Trichophyton rubrum infection (n = 1). Four patients died due to sepsis from disseminated infection. Subcutaneous nodules may reflect a systemic infectious pathology. In some cases, the investigation of cutaneous lesions is important to reach a definitive diagnosis for possible future disseminated infections.