Skin cancer in solid organ transplant recipients: Advances in therapy and management : Part I. Epidemiology of skin cancer in solid organ transplant recipients - 28/07/11

Doi : 10.1016/j.jaad.2010.11.062

Fiona O’Reilly Zwald, MD ^a,^⁎ , Marc Brown, MD ^b
^a Department of Dermatology and Division of Transplantation, Department of Surgery, Emory University, Atlanta, Georgia
^b Department of Dermatology and Oncology, University of Rochester, Rochester, New York

Reprint requests: Fiona O’Reilly Zwald, MD, MRCPI, Mohs Micrographic Surgery, Transplant Dermatology, Department of Dermatology, Emory University School of Medicine, 1365 Clifton Road NE, Ste 1400-A Bldg, Atlanta, GA 30322.

Abstract

Skin cancer is the most frequent malignancy in organ transplant recipients, 95% of which are nonmelanoma skin cancer, especially squamous cell and basal cell carcinomas. This paper also discusses the incidence of other tumors (eg, melanoma, Merkel cell carcinoma, and Kaposi sarcoma) that are also increased in organ transplant patients compared to the general population. Part I of this two-part series describes the latest data concerning the epidemiologic and pathogenic aspects of nonmelanoma skin cancer development in solid organ transplant recipients. This review also highlights the concept of “field cancerization,” represented by extensive areas of actinic damage and epidermal dysplasia, which accounts for increased risk of aggressive skin cancer development in susceptible patients.

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Key words : immunosuppression, nonmelanoma skin cancer, organ transplant recipients, sirolimus, voriconazole