Risk of infectious diseases and cutaneous tumours in solid organ recipients: A meta-analysis of literature

AIM: To compare the risk of cutaneous infections and tumours in kidney transplant recipients with data recently published about this topic.METHODS: In the present work, we evaluated the incidence of bacterial, fungal and viral cutaneous infectious diseases and the development of skin cancers in a cohort of 436 patients who underwent a renal transplantation. The median age at transplantation of our patients was 50 years and the median duration of the immunosuppression was of 7.2 years. Data obtainedfrom our cohort were compared with those obtained by a systematic review of the literature of the last 20 years about the same topic.RESULTS: Infectious diseases were the most frequent dermatological disorders that were diagnosed after transplantation, affecting about the 16.5% of patients. Herpes virus reactivation occurs in about the 35% of patients and is more common within 6 mo from transplantation, whereas when the immunosuppression is reduced, skin infections are mainly represented by Human Papilloma Virus infections and localized mycosis, such as pityriasis versicolor and superficial candidiasis. Bacterial infections were relatively rare and occur mainly in the first months after transplantation. The cumulative risk to develop skin cancer enhance significantly over the time, as consequence of longterm immunosuppressive regiments. Endogenous and exogenous risk factors, as well as the schedule of immunosuppression can play a role and justify the different incidence of skin cancer in the various series. CONCLUSION: Skin infections and cancer, commonly diagnosed in transplanted patients, impact on survival and life-quality, justifying the realization of follow-up programs for the early diagnosis and treatment.

Safety and immunogenicity of COVID-19 vaccination in immunocompromised patients

The coronavirus disease 2019(COVID-19)pandemic poses a great threat to public health.Individuals who are immunocompromised because of the progression of the primary disease or receiving immunosuppressive medications are prone to severe COVID-19 complications and poor outcomes.Abundant data have shown that many COVID-19 vaccines are safe and effective in large-scale populations;however,these clinical trials have excluded immunocompromised populations.Available evidence indicates that immunocompromised populations have a blunted immune response to other vaccines,raising concerns regarding the efficacy of COVID-19 vaccination in these populations.Thus,there is an urgent need to delineate the efficacy of COVID-19 vaccines in these vulnerable populations.Here,we review the characteristics of specific humoral and cellular responses to COVID-19 vaccination in immunocompromised populations,including HIV-infected patients and those receiving immunosuppressive treatment,especially solid organ transplant recipients and those undergoing anti-CD20 treatment.We also addressed the challenges that immunocompromised populations will face in the future pandemic and the need for basic and clinical translational studies to highlight the best vaccination strategies for these populations.