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

Doi : 10.1016/j.jaad.2010.11.063

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

The management of skin cancer in solid organ transplant recipients is a challenge to both the dermatologist and transplant physician. Part II of this continuing medical education review offers an approach to the management of this increasing problem. The importance of specialty dermatology clinics providing access to transplant patients, frequent skin cancer screening, patient education, and multidisciplinary care is discussed. The management of low risk squamous cell carcinoma with topical therapies, photodynamic therapy, systemic retinoids, and capecitabine is reviewed. Revision of immunosuppression in the management of high-risk patients is discussed in association with the potential role of sentinel lymph node biopsy for aggressive disease. Finally, management of in-transit and metastatic squamous cell carcinoma is reviewed, with a discussion of the role of more recent innovative therapies, including epidermal growth factor receptor inhibitors in advanced squamous cell carcinoma in solid organ transplant recipients.

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Key words : immunosuppression, nonmelanoma skin cancer, organ transplant recipients, radiotherapy, sentinel lymph node biopsy