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Previous Volume 332:1052-1057 April 20, 1995 Number 16 Next

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ABSTRACT

Background Renal-transplant recipients are known to have increased rates of skin cancer associated with exposure to the sun. Little is known, however, about the prevalence and histologic features of lesions of the lips in these patients, or about risk factors for such lesions.

Methods We examined the lips of 160 renal-transplant recipients (105 men and 55 women; mean [±SD] age, 48±13 years) and 160 normal subjects matched with the transplant recipients for age, sex, and skin type. The mean length of time between transplantation and the examination was 69±52 months; 58 percent of the recipients had received their grafts more than 60 months earlier.

Results Among the 160 renal-transplant recipients, 21 (13 percent) had leukoplakia; in 2 (1.2 percent) the leukoplakia contained squamous-cell carcinoma. In contrast, only one normal subject (0.6 percent) had leukoplakia. Histologically, 13 of the 21 leukoplakias (62 percent) in the renal-transplant recipients who underwent biopsy were dysplastic, and 2 (10 percent) contained squamous-cell carcinoma. Actinic change was evident in 91 percent of the dysplastic lesions but not in the nondysplastic lesions (P<0.001). Exposure to the sun and smoking were risk factors for dysplastic and malignant lip lesions in the renal-transplant recipients (P<0.001 and P = 0.003, respectively). Among these recipients, only men had dysplastic or malignant lip lesions (P = 0.006); lipstick was used frequently by 73 percent of the women. The clinical appearance of lip lesions did not predict the presence of dysplasia or cancer.

Conclusions Renal-transplant recipients have an increased prevalence of leukoplakia, dysplasia, and cancer of the lip.

Source Information

From the Departments of Oral Medicine and Periodontology (G.N.K., C.M.H., M.H.T.), Dermatology (M.T.G., I.M.L.), and Nephrology (J.T.C.K.), and the Joint Department of Oral Pathology with the Institute of Dental Surgery (D.M.W.), London Hospital Medical College, London, and the Department of Oral Health, University of Manchester, Manchester, United Kingdom (H.V.W.).

Address reprint requests to Dr. King at the Department of Oral Medicine and Periodontology, London Hospital Medical College, London E1 2AD, United Kingdom.

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