Sebaceous hyperplasia in organ transplant recipients: Shared aspects of hyperplastic and dysplastic processes?

Background: Patients receiving kidney or heart transplants are subject to a wide range of cutaneous changes attributed largely to the immunosuppression required to prevent rejection of their transplant. In addition to infection, they have an increased incidence of dysplastic lesions, some of which are malignant. Objective: Our purpose was to determine the incidence of sebaceous hyperplasia in heart and kidney transplant recipients and its association with neoplasia. Methods: Patients undergoing heart transplantation from a single transplant center were examined during a 30-month screening period to establish the prevalence of cutaneous abnormalities. Results: Sixteen of 104 (16%) heart transplant recipients had sebaceous hyperplasia in comparison with 1% of an age- and sex-matched control group. Those with sebaceous hyperplasia did not have a significantly higher incidence of hypertrichosis than those without sebaceous hyperplasia. Conclusion: Sebaceous hyperplasia is seen in heart transplant recipients. It does not appear to be connected with hypertrichosis, in which it is believed that the pilosebaceous unit is the target of the direct effects of cyclosporine. We propose that the development of sebaceous hyperplasia is related to the process of dysplastic epithelial proliferation in transplant recipients.