DermatopathologyClinicopathologic features of skin cancer in organ transplant recipients: A retrospective case-control series
Section snippets
Patients and tumors
Our institution has a dedicated organ transplant skin clinic in which a cohort of more than 800 renal transplant recipients (RTRs) has been under longitudinal study since 1989. Patients are seen within 12 months of transplantation and at least annually thereafter.5 For the purposes of this study, SCCs and BCCs from RTRs under the care of the transplant skin clinic and immunocompetent (IC) individuals attending general dermatology clinics were selected as follows: (1) SCCs: consecutive cases of
Results
A total of 325 consecutive NMSCs comprising 160 transplant tumors (60 SCCs, 100 BCCs) and 165 immunocompetent tumors (40 SCCs, 125 BCCs) were included in this study. For the SCC analysis, 109 primary cutaneous SCCs were recorded during 1995; 60 tumors arose in 26 RTRs and 49 tumors in 44 non-RTR patients. The non-RTR group included 9 SCCs from 5 patients with predisposing conditions other than renal transplantation (4 SCCs from one individual receiving psoralen plus ultraviolet A [PUVA]
Discussion
In this study we compare 160 transplant NMSCs and 165 immunocompetent NMSCs presenting consecutively to a single center with up to 10 years follow-up data. We report significant clinicopathologic differences associated with immune status. Transplant patients are 15 years younger at the time of NMSC diagnosis compared with immunocompetent individuals, and transplant tumors are more commonly multiple, are less prevalent on the head and neck, and are more frequently are located on the upper limbs.
References (44)
- et al.
Risk of neoplasia in renal transplant patients
Lancet
(1995) - et al.
Skin cancer in kidney and heart transplant recipients and different long-term immunosuppressive therapy regimens
J Am Acad Dermatol
(1999) - et al.
Non-melanoma skin cancer in renal transplant recipients: the extent of the problem and a strategy for management
Br J Plastic Surg
(1994) - et al.
Basal cell carcinomas and lymphoma: Biologic behaviour and associated factors in sixty-three patients
J Am Acad Dermatol
(1988) Sunlight and the onset of skin cancer
Trends Genet
(1997)- et al.
Histologic features of actinic keratoses in solid organ transplant recipients and healthy controls
J Am Acad Dermatol
(2001) - et al.
Epidermal dysplasia and neoplasia in kidney transplant recipients
J Am Acad Dermatol
(1995) - et al.
Cutaneous neoplasms in a military population of HIV-1 positive patients
J Am Acad Dermatol
(1993) - et al.
Differences in age, site distribution, and sex between nodular and superficial basal cell carcinomas indicate different types of tumours
J Invest Dermatol
(1998) - et al.
The effect of skin examination surveys on the incidence of basal cell carcinomas in a Queensland community sample: a 10-year longitudinal study
J Investig Dermatol Symp Proc
(2004)
Histologic pattern analysis of basal cell carcinoma. Study of a series of 1039 consecutive neoplasms
J Am Acad Dermatol
Papillomaviruses: death-defying acts in skin cancer
Trends Mol Med
The epidemiology of skin cancer
Br J Dermatol
Non-melanoma skin cancer and the ‘new National Health Service’: implicattions for UK dermatology?
Br J Dermatol
Skin cancers in renal-transplant recipients occur more frequently than previously recognized in a temperate climate
Transplantation
Non-melanoma skin cancer risk in the Queensland renal transplant population
Br J Dermatol
Skin cancers after organ transplantation
N Engl J Med
Aggressive-growth basal cell carcinoma in young adults
Arch Dermatol
Histologic patterns of basal cell carcinoma based upon patient immunostatus
Dermatol Surg
High recurrence rates of basal cell carcinoma after Mohs surgery in patients with chronic lymphocytic leukaemia
Arch Dermatol
Basal cell carcinomas developing in solid organ transplant recipients. Clinicopathologic study of 176 cases
Arch Dermatol
A role for sunlight in skin cancer: UV induced p53 mutations in squamous cell carcinoma
Proc Natl Acad Sci U S A
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Funding sources: C.A.H. and C.M.P. are supported by Cancer Research-UK.
Conflict of interest: None identified.