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Cutaneous Carcinogenesis in Organ Transplant Recipients

  • Joyce T. Yuan
  • Amanda R. Twigg
  • Sarah T. ArronEmail author
Chapter

Abstract

Organ transplant recipients (OTR) have a high risk of skin cancer, and skin cancer in OTR tends to be more aggressive. Skin cancer risk varies with immunosuppressive regimen. Azathioprine and cyclosporine are most associated with skin cancer, while sirolimus has a protective effect. OTR have a higher burden of actinic keratoses. Field treatments found to be safe and effective in OTR include diclofenac, imiquimod, 5-fluorouracil, and photodynamic therapy. Studies on ingenol mebutate in OTR are ongoing. Skin cancer chemoprevention with acitretin or nicotinamide should be considered in OTR with frequent skin cancers. Mohs micrographic surgery is often indicated in OTR. Dermatologic evaluation and management of OTR should include a thorough history taking and incorporation of patient preferences. There are currently no evidence-based consensus guidelines for skin cancer screening in OTR. Expert opinion recommends at least annual screening. A screening protocol for OTR based on a patient’s specific risk factors has been proposed.

Keywords

Skin cancer Cutaneous carcinogenesis Organ transplant recipients 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Joyce T. Yuan
    • 1
  • Amanda R. Twigg
    • 1
  • Sarah T. Arron
    • 1
    Email author
  1. 1.Department of DermatologyUniversity of California, San FranciscoSan FranciscoUSA

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