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Nonwhite transplant recipients show elevated risk for nonmelanoma skin cancer

Organ transplant recipients are at risk for developing skin cancer after transplantation, with nonwhite recipients showing an elevated incidence, according to study results in JAMA Dermatology.

In a retrospective study, the researchers reviewed the medical records of 413 organ transplant recipients (OTRs), including 264 men and 149 women, with a mean age of approximately 60 years. About 63% of these OTRs were nonwhite, and the researchers reported 15 nonwhite patients with 19 skin cancers. This included six black, five Asian and four Hispanic patients. Eighty-three percent of the cohort received a kidney transplant.

“Transplant recipients have a markedly higher incidence of new skin cancers, and this risk magnifies over time with continued exposure to immunosuppression,” Ellen N. Pritchett, MD, MPH, of the dermatology department at Henry Ford Hospital in Detroit, and colleagues wrote. “The increased risk of skin cancer is attributed to various factors that include duration and intensity of immunosuppression, the type of organ transplanted, and Fitzpatrick skin type, among others.”

Squamous cell carcinoma is the most common type of skin cancer found in black patients; however, the predominant malignant neoplasms diagnosed among the six patients in the cohort were squamous cell carcinomas in situ. Most of these lesions were found in the groin-genital area, and all of the patients endorsed a history of clinically evident condyloma acuminata (CA) or verruca vulgaris (VV) with two of three lesions testing positive for high risk of HPV types 16 and 18.

The majority of skins cancers found in the Asian patients (83.3%) were on sun-exposed areas and developed in a shorter time compared with the black patients. The researchers noted that this was likely because 75% of the Asian patients grew up near the equator and would have had increased sun exposure with intense UV radiation.

The Hispanic patients had two nonmelanoma skin cancers in sun-exposed locations and two on the lower extremities, but no results were drawn from these data.

All OTR patients, “regardless of race, should receive, at minimum, a baseline total-body skin examination and counseling regarding risk factors and photoprotection,” Pritchett and colleagues wrote. “A history of HPV, CA or VV should be obtained from all patients.” – by Talitha Bennett

Disclosure: The researchers report no relevant financial disclosures.