Prevention of skin cancer and reduction of keratotic skin lesions during acitretin therapy in renal transplant recipients: a double-blind, placebo-controlled study.

Bavinck, Jan Nico Bouwes; Tieben, L. M.; Woude, Fokko J. van der; Tegzess, Adam; Hermans, J.; Schegget, Jan ter; Vermeer, B.J.

doi:10.1200/jco.1995.13.8.1933

Cited by 359 publications

(255 citation statements)

References 17 publications

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“…Keratotic lesions increased by 28% in the placebo group and decreased by 13AE4% in the acitretin group. 52 The third study which compared different doses of acitretin did not show a difference in tumour rate between doses of 0AE4 mg kg )1 daily and 0AE4 mg kg )1 daily reducing to 0AE2 mg kg )1 for 9 months, nor a significant reduction compared with that observed in the preceding year without acitretin. 53 However, thickness of lesions was reduced and numbers of actinic keratoses were reduced.…”

mentioning

confidence: 99%

British Association of Dermatologists guidelines on the efficacy and use of acitretin in dermatology

Ormerod

Campalani

Goodfield

2010

British Journal of Dermatology

123

154

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mentioning

confidence: 99%

British Association of Dermatologists guidelines on the efficacy and use of acitretin in dermatology

Ormerod

Campalani

Goodfield

2010

British Journal of Dermatology

123

154

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“…Most of these trials focus on individuals at an increased risk of developing cancer, such as patients with pre-malignant lesions or patients who have been successfully treated for an early-stage carcinoma and have a high risk of developing a second primary cancer. The use of retinoids in patients with cutaneous actinic keratoses results in a significant decrease in the incidence of squamous cell carcinomas of the skin (Moon et al, 1997), and this is also observed in renal transplant patients with this pre-malignant condition (Bavinck et al, 1995;Rook et al, 1995). Similarly, topical ATRA can lead to a clinical and histological improvement in patients with the dysplastic nervous syndrome (Edwards and Jaffe, 1990;Halpern et al, 1994).…”

Section: Clinical Datamentioning

confidence: 95%

Retinoids: present role and future potential

1999

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Summary Vitamin A and its biologically active derivatives, retinal and retinoic acid (RA), together with a large repertoire of synthetic analogues are collectively referred to as retinoids. Naturally occurring retinoids regulate the growth and differentiation of a wide variety of cell types and play a crucial role in the physiology of vision and as morphogenic agents during embryonic development. Retinoids and their analogues have been evaluated as chemoprevention agents, and also in the management of acute promyelocytic leukaemia. Retinoids exert most of their effects by binding to specific receptors and modulating gene expression. The development of new active retinoids and the identification of two distinct families of retinoid receptors has led to an increased understanding of the cellular effects of activation of these receptors. In this article we review the use of retinoids in chemoprevention strategies, discuss the cellular consequences of activated retinoid receptors, and speculate on how our increasing understanding of retinoid-induced signalling pathways may contribute to future therapeutic strategies in the management of malignant disease.

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“…43 When confronted with perpetual development of cutaneous carcinomas, prophylactic systemic retinoids, derivatives of vitamin A, should be considered. [45][46][47] These agents, although not approved by the Food and Drug Administration for this indication, have potent prodifferentiation and tumor-suppressive effects. Unfortunately, systemic retinoids only suppress tumor development, not active skin cancers.…”

Section: Management Of Skin Cancer In Organ-transplant Recipientsmentioning

confidence: 99%

“…Acetretin, the most commonly used systemic retinoid, is administered orally at 25 mg/d, is usually well tolerated, and has not been shown to increase the risk for rejection. 46 Newer experimental retinoids may have a better side-effect profile and be tolerated as a chemopreventative agent for long durations. Monitoring serum lipid levels, hepatic function, and immunosuppressant levels is recommended when administering oral retinoids.…”

Section: Management Of Skin Cancer In Organ-transplant Recipientsmentioning

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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Prevention of skin cancer and reduction of keratotic skin lesions during acitretin therapy in renal transplant recipients: a double-blind, placebo-controlled study.

Cited by 359 publications

References 17 publications

British Association of Dermatologists guidelines on the efficacy and use of acitretin in dermatology

British Association of Dermatologists guidelines on the efficacy and use of acitretin in dermatology

Retinoids: present role and future potential

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