Study Emphasizes Importance of Skin Exams for Organ Transplant Recipients

Nonwhite organ transplant recipients are at risk for developing non-melanoma skin cancer following transplantation, and should receive baseline total-body skin examination and follow-up at a specialized transplant dermatology center, according to a study published in JAMA Dermatology.¹

Skin cancer among nonwhite patients is associated with increased morbidity and mortality, because it is often diagnosed at a more advanced stage. For this retrospective study, investigators analyzed data from 413 organ transplant recipients. Of those, 62.7% were nonwhite, which included 190 African American, 35 Asian, and 33 Hispanic patients.

Fifteen nonwhite patients developed histologically confirmed skin cancers, including 13 squamous cell carcinomas in situ, 1 squamous cell carcinoma, 4 basal cell carcinomas, and 1 sebaceous carcinoma. Investigators identified skin cancers in 6 African American, 5 Asian, and 4 Hispanic patients.

All skin cancers among black patients were diagnosed at an early stage, which was unexpected, because skin cancer among immunocompetent nonwhite patients is usually diagnosed at a more advanced stage. No African American patients were diagnosed with squamous cell carcinoma, despite its common occurrence among African Americans.

Most skin cancers among Asian patients were on sun-exposed areas; Asian patients had a shorter time to development of skin cancer.

Most squamous cell carcinomas in situ were found in the groin-genital area of African American patients, suggesting that patients should receive a baseline total-body skin examination that included inspection of the genitalia, groin, and perianal regions.

Reference

1. Pritchett EN, Doyle A, Shaver CM, et al. Nonmelanoma skin cancer in nonwhite organ transplant recipients. JAMA Dermatol. 2016 Sep 21. doi: 10.1001/jamadermatol.2016.3328 [Epub ahead of print]