Book contents
- Frontmatter
- Contents
- List of Contributors
- Foreword by Daniel R. Salomon
- Foreword by Robin Marks
- Foreword by Kathy Schwab
- Preface
- Acknowledgments
- SECTION ONE TRANSPLANT DERMATOLOGY: AN EVOLVING DYNAMIC FIELD
- Section Two Transplant Medicine and Dermatology
- Section Three Pathogenic Factors in Transplant Dermatology
- Section Four Cutaneous Effects of Immunosuppressive Medications
- Section Five Infectious Diseases of the Skin in Transplant Dermatology
- Section Six Benign and Inflammatory Skin Diseases in Transplant Dermatology
- Section Seven Cutaneous Oncology in Transplant Dermatology
- 20 The Pathogenesis of Skin Cancer in Organ Transplant Recipients
- 21 The Epidemiology of Skin Cancer in Organ Transplant Recipients
- 22 The Clinical Presentation and Diagnosis of Skin Cancer in Organ Transplant Recipients
- 23 Actinic Keratosis in Organ Transplant Recipients
- 24 Basal Cell Carcinoma in Organ Transplant Recipients
- 25 Squamous Cell Carcinoma in Organ Transplant Recipients
- 26 Malignant Melanoma in Organ Transplant Recipients
- 27 Merkel Cell Carcinoma in Organ Transplant Recipients
- 28 Kaposi's Sarcoma in Organ Transplant Recipients
- 29 Posttransplant Lymphoproliferative Disorder/Lymphoma in Organ Transplant Recipients
- 30 Rare Cutaneous Neoplasms in Organ Transplant Recipients
- 31 Histopathologic Features of Skin Cancer in Organ Transplant Recipients
- Section Eight Special Scenarios in Transplant Cutaneous Oncology
- Section Nine Educational, Organizational, and Research Efforts in Transplant Dermatology
- Index
25 - Squamous Cell Carcinoma in Organ Transplant Recipients
from Section Seven - Cutaneous Oncology in Transplant Dermatology
Published online by Cambridge University Press: 18 January 2010
- Frontmatter
- Contents
- List of Contributors
- Foreword by Daniel R. Salomon
- Foreword by Robin Marks
- Foreword by Kathy Schwab
- Preface
- Acknowledgments
- SECTION ONE TRANSPLANT DERMATOLOGY: AN EVOLVING DYNAMIC FIELD
- Section Two Transplant Medicine and Dermatology
- Section Three Pathogenic Factors in Transplant Dermatology
- Section Four Cutaneous Effects of Immunosuppressive Medications
- Section Five Infectious Diseases of the Skin in Transplant Dermatology
- Section Six Benign and Inflammatory Skin Diseases in Transplant Dermatology
- Section Seven Cutaneous Oncology in Transplant Dermatology
- 20 The Pathogenesis of Skin Cancer in Organ Transplant Recipients
- 21 The Epidemiology of Skin Cancer in Organ Transplant Recipients
- 22 The Clinical Presentation and Diagnosis of Skin Cancer in Organ Transplant Recipients
- 23 Actinic Keratosis in Organ Transplant Recipients
- 24 Basal Cell Carcinoma in Organ Transplant Recipients
- 25 Squamous Cell Carcinoma in Organ Transplant Recipients
- 26 Malignant Melanoma in Organ Transplant Recipients
- 27 Merkel Cell Carcinoma in Organ Transplant Recipients
- 28 Kaposi's Sarcoma in Organ Transplant Recipients
- 29 Posttransplant Lymphoproliferative Disorder/Lymphoma in Organ Transplant Recipients
- 30 Rare Cutaneous Neoplasms in Organ Transplant Recipients
- 31 Histopathologic Features of Skin Cancer in Organ Transplant Recipients
- Section Eight Special Scenarios in Transplant Cutaneous Oncology
- Section Nine Educational, Organizational, and Research Efforts in Transplant Dermatology
- Index
Summary
There are currently over 150,000 solid organ transplant recipients (OTRs) living in the United States. As more transplants are performed and postoperative survival improves, the complications of chronic immunosuppression, including development of cutaneous squamous cell carcinoma (SCC), have become more prevalent.
INCIDENCE
SCC occurs in OTRs with an incidence approximately 65 to 100 times that in the general population. In contrast to the nonimmunosuppressed population in which SCC is outnumbered by basal cell carcinoma at a 1:4 ratio, SCC occurs approximately 2 to 4 times more frequently than basal cell carcinoma in OTRs, making it the most common skin cancer in these patients.
The incidence of SCC in OTRs is related to the patient's age at transplantation, gender, skin phototype, degree of pretransplant and posttransplant ultraviolet radiation (UVR) exposure, and duration and level of immunosuppression. Chronic immunosuppression contributes to increased cutaneous malignancies, with the prevalence of nonmelanoma skin cancer (NMSC) reaching 40–75% 20 years after transplantation. OTRs with lighter skin phototypes, corresponding to a tendency to burn rather than tan with sun exposure, develop SCC at a higher frequency than those with darker phototypes residing in the same geographic area. Males experience a higher incidence of SCC than females, as do patients receiving their transplants at a greater age.
Residence in a geographic location with a lower latitude, and therefore higher ambient UVR exposure, is also associated with increased rates of SCC following transplantation.
- Type
- Chapter
- Information
- Skin Disease in Organ Transplantation , pp. 172 - 181Publisher: Cambridge University PressPrint publication year: 2008