Non-melanoma skin cancer in renal transplant recipients: the extent of the problem and a strategy for management

Glover, Mary; Niranjan, Niri S.; Kwan, Jonathan; Leigh, Irene M.

doi:10.1016/0007-1226(94)90164-3

Cited by 108 publications

(56 citation statements)

References 22 publications

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“…The incidence of skin cancers in RTRs has been reported from studies in Europe [23][24][25][26][27] and Australia [3,6]. The cumulative incidence of SCC and BCC twenty years post-transplantation has been reported to have reached 82% in Queensland, Australia [6], 40% in the UK [27], 41% in the Netherlands [7] and 15.3% in Italy [28]. The cumulative incidence at 10 years posttransplantation has been reported to be 18% in Canada [29], 10% in the Netherlands [7], 24.8% in the UK [19] and 45% in Queensland, Australia, at 11 years [3].…”

Section: Discussionmentioning

confidence: 99%

First and subsequent nonmelanoma skin cancers: incidence and predictors in a population of New Zealand renal transplant recipients

Mackenzie¹,

Wells

Lynn

et al. 2009

Nephrology Dialysis Transplantation

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Background. Renal transplant recipients (RTRs) have an increased risk of developing nonmelanoma skin cancers (NMSCs). The aims of this study were to determine the incidence and subsequent history of NMSCs in RTRs, together with risk factors. 14.2, 22.9) from transplant, as estimated by survival analysis. Individual predictors of first NMSC in RTRs were older age at first transplant (P < 0.0001), male sex (P = 0.006) and initial immunosuppression regimen (P = 0.001); only age (P < 0.0001) and male gender (P = 0.003) were significant predictors in a joint model. MethodsThe mean rate of subsequent NMSCs was 1.67 per year (95% CI = 1.32, 2.11). Older age at first renal transplant (P = 0.009) or at discovery of the first NMSC (P = 0.01) was associated with a higher annual rate of new NMSC following the discovery of the first NMSC. The median survival time to a second NMSC was 2.2 years (CI 1.4, 3.0). Fourteen patients died of metastatic squamous cell carcinoma (15% case fatality). Conclusions. NMSCs are a major health issue for RTRs, especially in older males. Once RTRs have developed their first NMSC, ongoing surveillance and prompt treatment are essential.

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Section: Discussionmentioning

confidence: 99%

First and subsequent nonmelanoma skin cancers: incidence and predictors in a population of New Zealand renal transplant recipients

Mackenzie¹,

Wells

Lynn

et al. 2009

Nephrology Dialysis Transplantation

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“…1 With respect to the detection and typing of HPV in common warts, few publications are available of studies conducted in the Brazilian population, the only study having been carried out in an immunocompetent population infected by the human immunodeficiency virus (HIV) and in patients with epidermodysplasia verruciformis. 3 Therefore, the objective of the present study was to evaluate the clinical and histopathological characteristics of common warts in kidney transplant recipients and identify the types of HPV present in the lesions.…”

confidence: 99%

Caracterização clínica e histopatológica e tipagem do papilomavírus humano das verrugas vulgares nos receptores de transplante renal

Martelli-Marzagão

Yamashiro

Ogawa

et al. 2010

An. Bras. Dermatol.

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Abstract:The prevalence of skin lesions caused by the human papillomavirus (HPV) is high in kidney transplant patients. Twenty recipients of kidney transplants with a diagnosis of common warts were evaluated. HPV detection was performed by polymerase chain reaction (PCR) using the MY09/MY11 and RK91 primers. HPV typing was performed by restriction fragment length polymorphism analysis and direct sequencing. The presence of HPV was identified in 10 patients (50%) and the types identified were HPV-2, 27, 29, 34 and 57. ©2010 by Anais Brasileiros de DermatologiaKidney transplant recipients have a 15-50% likelihood of developing common warts associated with the human papillomavirus (HPV) in the first year following the transplant and a 77-95% likelihood within five years. 1 With respect to the detection and typing of HPV in common warts, few publications are available of studies conducted in the Brazilian population, the only study having been carried out in an immunocompetent population infected by the human immunodeficiency virus (HIV) and in patients with epidermodysplasia verruciformis. 3 Therefore, the objective of the present study was to evaluate the clinical and histopathological characteristics of common warts in kidney transplant recipients and identify the types of HPV present in the lesions.Twenty kidney transplant recipients with a clinical and histopathological diagnosis of common warts were evaluated and submitted to HPV detection (using polymerase chain reaction [PCR] with the MY09/11 and RK91 primers) and typing (using restriction fragment length polymorphism analysis [RFLP] and/or direct sequencing).The mean age of the patients was 47.9 years. There was no difference in the incidence of the condi-

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“…Although metastasis from cutaneous squamous cell carcinoma is uncommon in the general population, approximately 5% to 7% of squamous cell carcinomas will metastasize in immunosuppressed transplant recipients. 15,16,39 Malignant melanoma, although uncommon in transplant recipients, is potentially lethal. It usually appears as a pigmented lesion with irregularities in symmetry, border, and coloration (Fig.…”

Section: Recognition Of Skin Cancermentioning

confidence: 99%

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2000

Liver Transpl

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Skin cancer is the most common malignancy arising in the posttransplantation setting. Multiple factors contribute to the high risk for cutaneous carcinoma in immunosuppressed organ-transplant recipients. We review the phenomenon of skin cancer in solid-organ transplant recipients and further delineate the problem in the context of liver transplantation. Skin cancer is a significant medical and surgical problem for organ-transplant recipients. With prolonged allograft function and patient survival, the majority of solid-organ transplant recipients will eventually develop skin cancer. Although squamous cell carcinoma is the most common cutaneous malignancy in this population, basal cell carcinoma, melanoma, and Kaposi's sarcoma, as well as uncommon skin malignancies, may occur. Highly susceptible patients may develop hundreds of squamous cell carcinomas, which may be life threatening. Management strategies focus on regular full-skin and nodal examination, aggressive treatment of established malignancies, and prophylactic measures to reduce the risk for additional photodamage and malignant transformation. Skin cancer is a substantial cause of morbidity and even mortality among solid-organ transplant recipients. As a byproduct of immunosuppression, liver transplant recipients experience a high incidence of skin cancer and should be educated and managed accordingly. (Liver Transpl 2000;6:253-262.) S kin cancer is the most common malignancy occurring in the setting of solid-organ transplantation and immunosuppression. The incidence of skin cancer increases substantially with extended survival after organ transplantation. Although for many patients, the cutaneous malignancies that arise are easily managed, there is a distinct subset of patients for whom major morbidity and even mortality may occur.Fortunately, skin cancer is a potentially preventable malignancy, and efforts increasingly are being directed to primary prevention in addition to treatment of skin cancers. Because the majority of organ-transplant recipients eventually develop skin cancer, it behooves the transplant physician and team to be knowledgeable about the early recognition of these lesions. Prompt referral to a dermatologist expert in the management of these patients is essential to minimize morbidity and occasional mortality.This review summarizes the skin cancer epidemic, the phenomenon of skin cancer in the setting of solid-organ transplantation, etiologic factors, and the recognition, management, and prevention of this substantial complication of transplantation-associated immunosuppression.

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Non-melanoma skin cancer in renal transplant recipients: the extent of the problem and a strategy for management

Cited by 108 publications

References 22 publications

First and subsequent nonmelanoma skin cancers: incidence and predictors in a population of New Zealand renal transplant recipients

First and subsequent nonmelanoma skin cancers: incidence and predictors in a population of New Zealand renal transplant recipients

Caracterização clínica e histopatológica e tipagem do papilomavírus humano das verrugas vulgares nos receptores de transplante renal

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