Histologic features of actinic keratoses in solid organ transplant recipients and healthy controls

Boyd, Alan S.; Stasko, Thomas; Cameron, Greg; Russell, Mark; King, Lloyd E.

doi:10.1067/mjd.2001.114740

Cited by 31 publications

(24 citation statements)

References 15 publications

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“…On average, BCCs develop in OTRs at a significantly younger age (15 years earlier) than in the general population. This trend-which was more pronounced for kidney than heart transplant recipients-has also been observed for other epithelial malignancies, including actinic keratoses, 24 SCC, 25 and Merkel cell carcinoma, 26 and could be due to the immunosuppressive treatment acting as a tumor promoter. As previously reported, 27 we did not observe any BCC in children who had undergone transplantation; however, one of the younger OTRs with BCC (aged 29 years at the time of BCC diagnosis) had undergone several renal transplantations during childhood, and it can be speculated that such patients may be at higher risk for BCC development because of the longer period of immunosuppression.…”

Section: Commentmentioning

confidence: 71%

Basal Cell Carcinomas Developing in Solid Organ Transplant Recipients

Kanitakis

Alhaj-Ibrahim²,

Euvrard³

et al. 2003

Arch Dermatol

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Section: Commentmentioning

confidence: 71%

Basal Cell Carcinomas Developing in Solid Organ Transplant Recipients

Kanitakis

Alhaj-Ibrahim²,

Euvrard³

et al. 2003

Arch Dermatol

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“…[10][11][12] In solid organ transplant patients, actinic keratosis occurs significantly earlier (54 vs 70 years). 13 Furthermore, it has been suggested that in patients with organ transplants and actinic keratosis, there is a higher accelerated progress of squamoproliferative neoplasms to invasive squamous cell carcinoma. 14 Actinic keratosis clinically presents as rough, pink, but circumscribed epidermal lesions (<1 cm in diameter), typically found on areas of the body exposed to sunlight (Fig.…”

Section: Nonmelanoma Skin Cancers (Keratinocytic Tumors) Actinic Keramentioning

confidence: 99%

Malignant Skin Neoplasms

Ricotti

Bouzari

Agadi³

et al. 2009

Medical Clinics of North America

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Skin cancer is the most common form of cancer in the United States, with the incidence increasing considerably. At current rates in the United States, a skin cancer will develop in 1 in 6 people during their lifetime.1 The most common of skin cancers may be categorized into 2 major groups: melanoma and nonmelanoma skin cancers. The latter group consists primarily of basal cell carcinomas and squamous cell carcinomas. Roughly 1,200,000 nonmelanoma skin cancers develop annually in the United States. These tumors are rarely fatal, but are considered to be fast growing tumors that if neglected may be locally and functionally destructive.In contrast, melanoma represents 5% of all diagnosed cancers in the United States, 15% of which prove to be fatal.3 Although melanoma is seen more with increasing age, it is the most frequent cancer plaguing women aged 25 to 29 years, and the second most frequent cancer afflicting women aged 30 to 34.2 Tumor depth is the most important prognostic indicator for melanoma, thus early recognition and management are imperative for improved therapeutic outcome.Although the nonmelanoma and melanoma skin cancers encompass the vast majority of skin cancers, there is a large number of other malignancies of the skin that are less commonly confronted by the clinician. Neoplasms of the skin classically have been divided into those that differentiate from the epidermis, dermis, adnexal structures of the skin, and those derived systemically. This review focuses on the most frequent malignant neoplasms, and divides them into those that are classically designated nonmelanoma skin cancers (also known as keratinocytic tumors), melanoma, and other less common skin cancers of the skin. An extensive list of skin malignancies is provided in Box 1.

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“…AK also progress more rapidly and frequently than normal into SCC, which in turn exhibits a stronger tendency to metastasize. AK has been calculated to appear 15 years earlier on average in OTR than in a control population (55 versus 70 years) (12) The incidence of KS is much higher in transplant recipients than innon-immunosuppressedpopulations (by a factor of 84 to 500) (13). The incidence of KS increases with duration of immunosuppressive treatment, with actually more than 5% of all de novo tumors in this group of patients being KS (13).…”

Section: Otr Patients: a Vulnerable Population With Particular Needsmentioning

confidence: 99%

Efforts to Counteract Locally the Effects of Systemic Immunosupression: A Review on the Use of Imiquimod, a Topical Immunostimulator in Organ Transplant Recipients

Trakatelli

Katsanos

Ulrich

et al. 2010

Int J Immunopathol Pharmacol

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The potent systemic immunosuppression therapy necessary to sustain a life-saving solid organ transplant is associated with an increased incidence of various infections including human papillomavirus infection and skin cancers in organ transplant recipients. Imiquimod, a topical agent that functions through local induction of a specific anti-viral or anti-tumor immune response, appears to be a promising therapeutic option that could potentially counteract in situ the effects of systemic immunosupression in this vulnerable group. Up-to-date studies using this local immune-response modifier in transplanted patients have yielded reassuring and encouraging results regarding its safety and efficacy in this population. However, in order to establish the use of imiquimod as a standard treatment option for organ transplant recipients, additional research and clinical trials are required.The past decades have seen unprecedented progress in the development of solid organ transplantation as a therapeutic choice for endstage organ disease. Organ Transplant Recipients (OTR) live longer, have a good quality of life and represent a rapidly growing population of people with specific medical needs. As the number of solid organ transplants continues to rise, so too does the number of various infections including human papillomavirus (HPV) infections and skin cancers in OTR. Consequently, physicians will be called upon to manage these diseases in the sensitive OTR population and to develop novel therapeutic and preventive strategies to better deal with them.The clinical efficacy of imiquimod 5% cream (a topical therapy approved for genital warts, actinic keratoses and superficial basal cell carcinoma) stems from stimulation ofinnate and cell-mediated immune responses, resulting in antiviral, antiproliferative and antitumor activity. Because of these properties, imiquimod and other members of this family of immune response modifiers are potential agents for treatment of conditions where the immune system can affect the regression of the disease (1). In light of the role of systemic immunosupression in the development of cutaneous infections and neoplasms in OTR, the use of imiquimod to locally stimulate immune responses against cancerous, pre-cancerous

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Histologic features of actinic keratoses in solid organ transplant recipients and healthy controls

Cited by 31 publications

References 15 publications

Basal Cell Carcinomas Developing in Solid Organ Transplant Recipients

Basal Cell Carcinomas Developing in Solid Organ Transplant Recipients

Malignant Skin Neoplasms

Efforts to Counteract Locally the Effects of Systemic Immunosupression: A Review on the Use of Imiquimod, a Topical Immunostimulator in Organ Transplant Recipients

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