The burden of cutaneous disease in solid organ transplant recipients of color

Abstract

Organ transplant recipients (OTRs) are at increased risk of cutaneous malignancy. Skin disorders in OTRs of color (OTRoC) have rarely been systematically assessed. We aimed to ascertain the burden of skin disease encountered in OTRoC by prospectively collecting data from OTRs attending 2 posttransplant skin surveillance clinics: 1 in London, UK and 1 in Philadelphia, USA. Retrospective review of all dermatological diagnoses was performed. Data from 1766 OTRs were analyzed: 1024 (58%) white, 376 (21%) black, 261 (15%) Asian, 57 (3%) Middle Eastern/Mediterranean (ME/M), and 48 (2.7%) Hispanic; and 1128 (64%) male. Viral infections affected 45.1% of OTRs, and were more common in white and ME/M patients (P < .001). Fungal infections affected 28.1% and were more common in ME/M patients (P < .001). Inflammatory skin disease affected 24.5%, and was most common in black patients (P < .001). In addition, 26.4% of patients developed skin cancer. There was an increased risk of skin cancer in white vs nonwhite OTRs (HR 4.4, 95% CI 3.5‐5.7, P < .001): keratinocyte cancers were more common in white OTRs (P < .001) and Kaposi sarcoma was more common in black OTRs (P < .001). These data support the need for programs that promote targeted dermatology surveillance for all OTRs, regardless of race/ethnicity or country of origin.

Skin cancer incidence in Mexican renal transplant recipients: a cohort over 56 years

“…SCC likely stems from UV radiation and HPV exposure, while BCC shows no significant association with HPV 16 . While data from South Africa and Saudi Arabia highlight increased KS incidence in non‐White SOTRs, 4 this trend was not observed in our cohort.…”

Skin cancer incidence in Mexican renal transplant recipients: a cohort over 56 years

“…SCC likely stems from UV radiation and HPV exposure, while BCC shows no significant association with HPV 16 . While data from South Africa and Saudi Arabia highlight increased KS incidence in non‐White SOTRs, 4 this trend was not observed in our cohort.…”

Skin cancer in renal transplant recipients: outcomes from a safety net hospital in Boston

“…In the present study FPI‐II patients had a predictably higher incidence of skin cancer (15.1%) compared to those with FPIII‐VI (2.8%). Other studies in RTRs looking specifically at PwSOC have shown comparable results with rates of 3.3% 10 . A skin cancer incidence of 2.8% in the FPIII‐VI group is far greater than the expected risk of NMSC in PwSOC in the nontransplant population, where incidence rates of cSCC have been reported to be 0.0035% for Black patients, 0.0058% in Chinese patients, 0.015% in Japanese patients, and 0.05% in SE Arizona Hispanics.…”

“…Other studies in RTRs looking specifically at PwSOC have shown comparable results with rates of 3.3%. 10 A skin cancer incidence of 2.8% in the FPIII-VI group is far greater than the expected risk of NMSC in PwSOC in the nontransplant population, where incidence rates of cSCC have been reported to be 0.0035% for Black patients, 0.0058% in Chinese patients, 0.015% in Japanese patients, and 0.05% in SE Arizona Hispanics. The incidence of BCC in the nontransplant population has been documented as 0.0015% in Blacks, 0.0061% in Chinese patients, 0.01575% in Japanese, 0.0705% in SE Arizona Hispanics, and 0.142% in New Mexican Hispanics.…”

Identifying risk factors for cutaneous disease among solid organ transplant recipients: A retrospective review

“… 5 Most commonly, these conditions include cutaneous malignancy, precancerous lesions, as well as inflammatory and infectious diseases. 6 , 7 As demonstrated by our cohort, SOTRs tend to be older, White, men, and kidney transplanted is most frequently performed. 1…”

Skin cancer incidence in Mexican renal transplant recipients: a cohort over 56 years

“…SCC likely stems from UV radiation and HPV exposure, while BCC shows no significant association with HPV 16 . While data from South Africa and Saudi Arabia highlight increased KS incidence in non‐White SOTRs, 4 this trend was not observed in our cohort.…”

Skin cancer in renal transplant recipients: outcomes from a safety net hospital in Boston

“…In the present study FPI‐II patients had a predictably higher incidence of skin cancer (15.1%) compared to those with FPIII‐VI (2.8%). Other studies in RTRs looking specifically at PwSOC have shown comparable results with rates of 3.3% 10 . A skin cancer incidence of 2.8% in the FPIII‐VI group is far greater than the expected risk of NMSC in PwSOC in the nontransplant population, where incidence rates of cSCC have been reported to be 0.0035% for Black patients, 0.0058% in Chinese patients, 0.015% in Japanese patients, and 0.05% in SE Arizona Hispanics.…”

“…Other studies in RTRs looking specifically at PwSOC have shown comparable results with rates of 3.3%. 10 A skin cancer incidence of 2.8% in the FPIII-VI group is far greater than the expected risk of NMSC in PwSOC in the nontransplant population, where incidence rates of cSCC have been reported to be 0.0035% for Black patients, 0.0058% in Chinese patients, 0.015% in Japanese patients, and 0.05% in SE Arizona Hispanics. The incidence of BCC in the nontransplant population has been documented as 0.0015% in Blacks, 0.0061% in Chinese patients, 0.01575% in Japanese, 0.0705% in SE Arizona Hispanics, and 0.142% in New Mexican Hispanics.…”

Identifying risk factors for cutaneous disease among solid organ transplant recipients: A retrospective review

“… 5 Most commonly, these conditions include cutaneous malignancy, precancerous lesions, as well as inflammatory and infectious diseases. 6 , 7 As demonstrated by our cohort, SOTRs tend to be older, White, men, and kidney transplanted is most frequently performed. 1…”

Skin cancer incidence in Mexican renal transplant recipients: a cohort over 56 years

“…SCC likely stems from UV radiation and HPV exposure, while BCC shows no significant association with HPV 16 . While data from South Africa and Saudi Arabia highlight increased KS incidence in non‐White SOTRs, 4 this trend was not observed in our cohort.…”

Skin cancer in renal transplant recipients: outcomes from a safety net hospital in Boston

“…In the present study FPI‐II patients had a predictably higher incidence of skin cancer (15.1%) compared to those with FPIII‐VI (2.8%). Other studies in RTRs looking specifically at PwSOC have shown comparable results with rates of 3.3% 10 . A skin cancer incidence of 2.8% in the FPIII‐VI group is far greater than the expected risk of NMSC in PwSOC in the nontransplant population, where incidence rates of cSCC have been reported to be 0.0035% for Black patients, 0.0058% in Chinese patients, 0.015% in Japanese patients, and 0.05% in SE Arizona Hispanics.…”

“…Other studies in RTRs looking specifically at PwSOC have shown comparable results with rates of 3.3%. 10 A skin cancer incidence of 2.8% in the FPIII-VI group is far greater than the expected risk of NMSC in PwSOC in the nontransplant population, where incidence rates of cSCC have been reported to be 0.0035% for Black patients, 0.0058% in Chinese patients, 0.015% in Japanese patients, and 0.05% in SE Arizona Hispanics. The incidence of BCC in the nontransplant population has been documented as 0.0015% in Blacks, 0.0061% in Chinese patients, 0.01575% in Japanese, 0.0705% in SE Arizona Hispanics, and 0.142% in New Mexican Hispanics.…”

Identifying risk factors for cutaneous disease among solid organ transplant recipients: A retrospective review

“… 5 Most commonly, these conditions include cutaneous malignancy, precancerous lesions, as well as inflammatory and infectious diseases. 6 , 7 As demonstrated by our cohort, SOTRs tend to be older, White, men, and kidney transplanted is most frequently performed. 1…”