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.
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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.
- 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]