INTRODUCTION

Organ transplantation has gained increasing acceptance as the treatment of choice for many end-stage organ diseases in pediatric patients. Organ transplantation in recipients younger than 18 years of age accounts for 4–7% of all transplantations. The life-long immunosuppression required for graft survival predisposes these patients to various neoplastic disorders. Transplant patients have an overall 5–6% incidence of malignancies, which is 100 times greater than the general population. Although skin cancers are the most common malignant condition in adult organ transplant recipients, posttransplant lymphoproliferative disorder (PTLD) constitutes the most prevalent posttransplantation malignancy in pediatric recipients. Skin carcinoma is the second most frequent malignancy associated with pediatric transplantation. Although there are multiple studies on skin cancers in adult organ transplant recipients, only a few studies have focused on skin malignancies in pediatric transplant patients. In addition, considering the retrospective design and lack of long-term follow-up in these studies, it seems that they can not provide a complete picture of the frequency, type, and outcome of skin malignancies in pediatric transplant recipients particularly as they transition into adulthood. Prospective studies of larger numbers of pediatric transplant recipients and longer follow-up periods are needed. This chapter is based on the available data regarding skin cancer in pediatric solid organ transplant recipients.

NONMELANOMA SKIN CANCER

Solid organ transplant recipients have an increased risk of skin cancer compared to the general population. Nonmelanoma skin cancer, including primarily squamous and basal cell carcinomas, account for more than 90% of all skin cancers in adult transplant recipients.