Epidemiology and risk factors for skin cancer in solid organ transplant recipients
- Thomas Stasko, MD
Thomas Stasko, MD
- Professor and Chair - Department of Dermatology
- The University of Oklahoma Health Sciences Center
- Allison M Hanlon, MD
Allison M Hanlon, MD
- Assistant Professor
- Division of Dermatology
- Mohs Dermatologic Surgery
- Department of Medicine
- Vanderbilt University
The long-term immunosuppressive therapy required to maintain host tolerance of a transplanted organ contributes to an increased risk for malignancy in organ transplant recipients. Skin is the most common site for the development of malignancy; in particular, cutaneous squamous cell carcinomas (SCC) and basal cell carcinomas (BCC) are frequently detected . A variety of factors, including the intensity and duration of immunosuppression, patient ethnic background, patient sun exposure history, and geographic location, can influence the likelihood for the development of skin cancer in these patients.
The most common skin cancers that develop in solid organ transplant recipients will be reviewed here. The management of skin cancer in solid organ transplant recipients and information on other malignancies in organ transplant recipients are discussed elsewhere. (See "Prevention and management of skin cancer in solid organ transplant recipients" and "Development of malignancy following solid organ transplantation" and "Epidemiology, clinical manifestations, and diagnosis of post-transplant lymphoproliferative disorders".)
Skin cancers account for almost 40 percent of malignancies in organ transplant recipients, and develop in more than 50 percent of white organ transplant recipients [2,3]. The most commonly reported skin cancers in this population include squamous cell carcinoma (SCC), basal cell carcinoma (BCC), melanoma, and Kaposi sarcoma [2,4-6].
Although the pathways that lead to an elevated risk for cutaneous malignancy in organ transplant recipients are not fully understood, it generally is accepted that immunosuppressive medications used to induce tolerance to the donor organ play an important role. Proposed mechanisms through which immunosuppression may contribute to the development of skin cancer include :
●Reduced immune surveillance, thereby facilitating the survival and proliferation of atypical cells.
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