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SKIN CANCERS
ORGAN TRANSPLANT RECIPIENTS
DIFFER FROM NON-TRANSPLANT PATIENTS

CHICAGO: "Skin cancers differ among patients who have received organ transplants compared with non-transplant patients, according to an article in the September issue of The Archives of Dermatology, one of the JAMA/Archives journals."

Organ transplant recipients (OTRs) are at an increased risk for developing cancers including skin cancers, according to the article. "Basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs), two forms of skin cancer, are among the most common cancers that develop in transplant recipients as a result of immunosuppression from drugs that need to be taken over long periods of time to prevent organ rejection, and light exposure. These skin cancers affect up to 40 percent of OTRs within 20 years of transplantation and account for a mortality rate of 5 percent to 8 percent."

Jean Kanitakis, M.D., of Edouard Herriot Hospital, Lyon, France, and colleagues described the clinical features of BCCs in organ transplant recipients.

Of 2,029 OTRs followed at the authors' center over 20 years, 146 patients developed 176 clinically diagnosed BCCs. The authors compared these cancers to 153 BCCs from 141 non-immunosuppressed patients (patients who never received an organ transplant) as controls. The researchers found that BCCs developed an average of 6.9 years after transplantation, sooner after heart transplants than kidney transplants, and were especially common in patients who received heart tissue transplants. The average age of transplant recipients with BCCs was lower than that of control patients (54.6 vs. 69.8 years), especially for patients with kidney transplants.

In both OTRs and non-transplant patients, the BCCs were found mostly on the head and neck. However, BCCs occurred more frequently inother body areas in OTRs (37.5 percent) than in controls (24.5 percent), and superficial BCCs were more common in transplant recipients than controls (33.6 percent vs. 14.4 percent).

"Basal cell carcinomas in transplant recipients show some clinicopathologic differences from their `ordinary' counterparts, namely, a younger age at development, male preponderance, more frequent distribution in extracephalic sites [areas other than the head and neck], and higher frequency of superficial subtypes," the authors write.

(Arch Dermatol [2003;139:1133-1137]; Available at archdermatol.com)

For additional pictures and information about basal cell carinomas, the following site is excellent.
http://dermnetnz.org/lesions/basal-cell-carcinoma.html

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