Skin cancer in solid organ transplant recipients: still an open problem

Granata, Simona; Tessari, Gianpaolo; Stallone, Giovanni; Zaza, Gianluigi

doi:10.3389/fmed.2023.1189680

Cited by 9 publications

(4 citation statements)

References 73 publications

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“…Complications of skin cancer resulting from immunosuppression in transplant patients pose a significant clinical challenge and therefore, diagnostic tools are crucial for enhancement of early diagnostic and management of complications of skin cancer patients [13].…”

Section: Discussionmentioning

confidence: 99%

Routine outpatient dermatological evaluation of kidney transplant recipients using dermatoscopy as an additional tool: a preliminary analysis

Caldas,

Abbud-Filho

et al. 2023

Preprint

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Introduction. Non-melanoma skin cancer (NMSC) is the most common malignancy following renal transplantation and leads to significant years of potential life lost. Dermatoscopy use in the routine clinical setting has shown promise in increasing the diagnosis of NMSC. Objectives. 1) To assess the prevalence of NMSC in renal transplant recipients (RTx) using the dermatoscopy (DC); 2) to identify associated risk factors; 3) to compare the accuracy of dermatoscopy with histopathological results. Methods. A prospective study was conducted from January 2022 to January 2023 and 100 RTx from the outpatient clinic were randomly referred for dermatological examination and then divided into two groups: with NMSC (NMSC; n=39) and without NMSC (non-NMSC; n=61). RTx variables related to habits, tumor characteristics, and transplantation were analyzed. Results: Clinical dermatological evaluation identified 23 squamous cell carcinoma (SCC) (59%) and 16 basal cell carcinoma (BCC) (41%). Factors associated with NMSC included: male gender (OR=2); age over 50 years (OR=5.4); occupational sun exposure (OR=2.5); recreational sun exposure (OR=4.9); actinic keratosis (OR=6.5); family history of NMSC (OR=7.6); and induction with thymoglobulin (OR=2.4). The accuracy rate between clinical diagnosis and dermatoscopy compared to the final histological result after biopsy was 81.25% for suspected NMSC cases. Conclusions: NMSC occurred in 39% of the evaluated RTx cases, with a family history and actinic keratosis being the main risk factors. Dermatoscopy diagnosed NMSC in 81%, and therefore, we suggest that this examination should be incorporated into routine evaluation.

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Section: Discussionmentioning

confidence: 99%

Routine outpatient dermatological evaluation of kidney transplant recipients using dermatoscopy as an additional tool: a preliminary analysis

Caldas,

Abbud-Filho

et al. 2023

Preprint

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“…The different therapeutic options for the management of AK have been discussed recently and it is important to note they may be complemented by a concomitant reduction or a switch of the immunosuppressive treatment. 64…”

Section: Nonementioning

confidence: 99%

Actinic keratosis: Current challenges and unanswered questions

Malvehy,

Stratigos,

Bagot

et al. 2024

Acad Dermatol Venereol

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Actinic keratoses (AK) are common skin lesions associated with chronic exposure to sun. They are believed to be precursors of malignancy as they potentially may progress to invasive squamous cell carcinomas. The goal of current therapies is to reduce the number of AK and to prevent future cancer development. This review aims at providing an overview of the hallmarks of AK and skin field cancerization. We discuss epidemiology trends, risk factors and the state of the art and evidence of the current treatments. We review key figures of AK prevalence from different countries with regard to skin cancer risk and the associated economic burden of AK. We discuss the mutational status in AK lesions and the difficulties encountered by clinicians in evaluating AK visible and invisible lesions, referring to the concept of field cancerization. Based on a systematic literature review, we further evaluate the available treatment options. The presence of subclinical skin alterations in the periphery of visible AK lesions has gained a particular attention as those non‐visible lesions are known to contain the same genetic changes as those found in the AK lesions themselves, prompting the concept of ‘field cancerization’. Therefore, AK treatment guidelines now recognize the importance of treating the field in patients with AK. A recent systematic literature review and network meta‐analysis showed that 5‐FU interventions were associated with the best efficacy and a satisfactory acceptability profile compared with other field‐directed therapies used in the treatment of AK. Although AK are considered quite common, they lack an accurate descriptive definition and conclusive epidemiologic data. Limited public awareness is a barrier to early and effective treatment, including prevention strategies. While different treatment options are available, there is still a limited understanding of long‐term outcomes of treatment as measured by recurrence of cancer prevention.

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“…Much of the existing literature derives from studies on OTRs, which represent the majority of the immunocompromised population. The cumulative incidence is related to geographic latitude, skin type, and immunosuppressive therapies [23]. Indeed, the risk appears to be correlated with the level of immunosuppression in the transplant (heart > kidney > liver) [24].…”

Section: Introductionmentioning

confidence: 99%

Photodynamic Therapy for the Treatment of Bowen’s Disease: A Review on Efficacy, Non-Invasive Treatment Monitoring, Tolerability, and Cosmetic Outcome

Antonetti,

Pellegrini,

Caponio

et al. 2024

Biomedicines

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Bowen’s disease represents the in situ form of cutaneous squamous cell carcinoma; although it has an excellent prognosis, 3–5% of lesions progress to invasive cutaneous squamous cell carcinoma, with a higher risk in immunocompromised patients. Treatment is therefore always necessary, and conventional photodynamic therapy is a first-line option. The aim of this review is to provide an overview of the clinical response, recurrence rates, safety, and cosmetic outcome of photodynamic therapy in the treatment of Bowen’s disease, considering different protocols in terms of photosensitizers, light source, and combination treatments. Photodynamic therapy is a valuable option for tumors at sites where wound healing is poor/delayed, in the case of multiple and/or large tumors, and where surgery would be difficult or invasive. Dermoscopy and reflectance confocal microscopy can be used as valuable tools for monitoring the therapeutic response. The treatment is generally well tolerated, with mild side effects, and is associated with a good/excellent cosmetic outcome. Periodic follow-up after photodynamic therapy is essential because of the risk of recurrence and progression to cSCC. As the incidence of keratinocyte tumors increases, the therapeutic space for photodynamic therapy will further increase.

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Skin cancer in solid organ transplant recipients: still an open problem

Cited by 9 publications

References 73 publications

Routine outpatient dermatological evaluation of kidney transplant recipients using dermatoscopy as an additional tool: a preliminary analysis

Routine outpatient dermatological evaluation of kidney transplant recipients using dermatoscopy as an additional tool: a preliminary analysis

Actinic keratosis: Current challenges and unanswered questions

Photodynamic Therapy for the Treatment of Bowen’s Disease: A Review on Efficacy, Non-Invasive Treatment Monitoring, Tolerability, and Cosmetic Outcome

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