Cutaneous Squamous Cell Carcinoma in Immunosuppressed Patients

Tam, Samantha; Gross, Neil D.

doi:10.1007/s11912-019-0831-1

Cited by 10 publications

(12 citation statements)

References 52 publications

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“…These patients often have more advanced or complex presentations and are recognized to be at increased risk for the development of cutaneous malignancies, particularly SCC. 138,139 A lack of evidence prevented development of recommendations for treatment in this patient population. The high level of evidence required from larger RCTs can be difficult to achieve for interventions when the patient population is constricted to a very specific subset, such as patients with chronic lymphocytic leukemia or with solid organ transplants.…”

Section: Immunocompromised Patientsmentioning

confidence: 99%

Guidelines of care for the management of actinic keratosis

Eisen

Asgari

Bennett

et al. 2021

Journal of the American Academy of Dermatology

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Section: Immunocompromised Patientsmentioning

confidence: 99%

Guidelines of care for the management of actinic keratosis

Eisen

Asgari

Bennett

et al. 2021

Journal of the American Academy of Dermatology

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“…Considering the aggressiveness of CSCC in SOTR, treatment of pre-malignant lesions should be sought out and if there is suspicion of transformation into malignant lesions, biopsy or excision should be performed. 38 In terms of topical therapies for the treatment of actinic keratosis, there is a wide range of options available: diclofenac, 5-fluorouracil, imiquimod, laser, cryotherapy, among others. 22,38 In single lesions, local destructive options, such as cryotherapy or electrocautery and curettage can be considered.…”

Section: Treatmentmentioning

confidence: 99%

“…38 In terms of topical therapies for the treatment of actinic keratosis, there is a wide range of options available: diclofenac, 5-fluorouracil, imiquimod, laser, cryotherapy, among others. 22,38 In single lesions, local destructive options, such as cryotherapy or electrocautery and curettage can be considered. Clearance of 41% of lesions has been achieved with topical diclofenac and 62% clearance has been obtained with topical imiquimod.…”

Section: Treatmentmentioning

confidence: 99%

“…42 For areas with extensive lesions, photodynamic therapy should be considered, and has been proven to be more effective than imiquimod. 38,43 For CSCC, surgery is the gold standard treatment, not only because it allows tumor removal but also histologic verification. 44 The recommended surgical margins depend on the size of the tumor, with margins of 0.4 cm being advocated for tumors inferior to 2 cm, and margins of 0.6 cm for tumors larger than 2 cm.…”

Section: Treatmentmentioning

confidence: 99%

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Cutaneous Squamous Cell Carcinoma in Solid Organ Transplant Patients

Silva

Borges‐Costa

2020

SPDV

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Solid organ transplant recipients (SOTR) are more likely to develop cutaneous squamous cell carcinoma (CSCC), compared to the general population. This increased incidence is due to several factors including chronic ultraviolet radiation exposure, human papillomavirus (HPV) infection, immunosuppressive medication, among others. Primary prevention is crucial, because not only are cutaneous squamous cell carcinomas more frequent in SOTR, but they are also more aggressive and have therefore a worse prognosis. Newer immunosuppressive drugs are associated with a smaller risk of developing CSCC, but they can have more adverse events, prompting patients to abandon therapy. Concerning treatment options for CSCC, they range from surgery, radiotherapy, and systemic therapy, although there are few studies in SOTR concerning the use of immunotherapy and epidermal growth factor receptor (EGFR) inhibitors.

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“…2 Patients with CLL have an immunosuppressed status due to the intrinsic nature of the disease, its treatment, or both. 3 …”

Section: Introductionmentioning

confidence: 99%

Cutaneous squamous cell carcinoma in patients with chronic lymphocytic leukemia: a systematic review of the literature

et al. 2021

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The continuous improvement of life expectancy of patients with chronic lymphocytic leukemia (CLL) has resulted in increased risk of second primary malignancy that potentially may affect survival and quality of life of CLL patients. We performed a systematic review to assess the risk and the clinical‐pathological features and prognosis of cutaneous squamous cell carcinoma (cSCC) in patients with CLL. We searched PubMed, Embase, and Cochrane Central Register of Control Trials databases for articles published from database inception to December 31, 2019. English‐language studies reporting original data on patients with a specific diagnosis of CLL and cSCC were included. Data were extracted using a standardized extraction form, and any discordance was resolved by consensus. Descriptive data were generated by pooling patients from eligible studies. Of the 4588 non‐duplicate records identified, 55 articles met our inclusion criteria. These studies reported that CLL patients have a 3.2% prevalence of cSCC, with an 11.5% cSCC‐related lethality and an overall risk of metastasis of 5.7% (7.3% for regional lymph node involvement and 3.8% for distant metastasis). The quality of evidence was limited by the high heterogeneity in the design, populations, and objectives of the included studies. This systematic review suggests that cSCC in CLL patients tends to behave less aggressively compared with the solid organ transplant recipients but has a higher morbidity and mortality than in the general population. Future prospective studies are needed to increase the quality of evidence and to determine the best treatment modalities and screening intervals for these patients.

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Cutaneous Squamous Cell Carcinoma in Immunosuppressed Patients

Cited by 10 publications

References 52 publications

Guidelines of care for the management of actinic keratosis

Guidelines of care for the management of actinic keratosis

Cutaneous Squamous Cell Carcinoma in Solid Organ Transplant Patients

Cutaneous squamous cell carcinoma in patients with chronic lymphocytic leukemia: a systematic review of the literature

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