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High risk of skin cancer for specific body areas seen in non-white organ transplant patients
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Organ transplant patients have an increased risk of skin cancer , with a high risk seen in non- white organ transplant patients for non-sun exposed areas, according to the presentation at the American Academy of Dermatology Summer Meeting.
“The non-white transplant recipients are at risk for developing skin cancer,” Christina Lee Chung, MD, FAAD, a board-certified dermatologist and former director of the Drexel Dermatology Center for Transplant Patients in Philadelphia, told Healio Nephrology. “They are significantly more at risk for developing skin cancer in non-sun exposed areas, in particular genital skin cancer in black patients. One-size-fits-all cannot be applied because early detection is key, and we have to be looking at the right places and we need to be evaluating risk factors in a culturally, racially specific manner when it comes to these patients.”
White vs non- white transplant patients
In a study that compared white transplant patients with non- w hite transplant patients, Chung and colleagues found Asian patients got fewer skin cancers compared with white patients , particularly in the face and upper extremities. While black and Latino patients got more skin cancers in “protected areas, like legs [and] genitals and the black patient population seems to be getting the highest concentration of skin cancer in the genital area.”
Chung said, “For our patient population, we decided, ‘Well we have such a high concentration of non-white patients that maybe what we need to do is modify ways we approach them because clearly their risks and their skin cancer development program profile is different.’ [What] we found was that our detection rate for skin cancer in those areas increased by more than six-fold.”
Chung said in her study cohort, although they increased screening for the genital area, the Caucasian transplant patients did not have any skin cancer. However, a higher rate of skin cancer in the genital region was seen in non-white transplant patients, especially for black patients even though white patients were 14 times more likely to develop skin cancer.
Skin cancer risk factors
Chung in her most recent study looked at skin cancer risk factors in organ transplant patients with darker skin tones. Some risk factors linked with an increased risk of skin cancer included a history of genital warts, genital HPV infection, whether patients presented from a sunny region and emigrated to the United States, history of warts in general, emigration to the United States from a country near the equator, history of sexually transmitted infections and taking medications for another condition prior to transplantation.
She noted other common factors that increase the risk of skin cancer include “if you have history of precancerous regions, thoracic transplant vs. abdominal transplant, if you’re older, time of transplantation, if you have fairer skin, if you had history of precancer or skin cancer — obviously those increase your risk but it looks like for the non-white transplant population, there will be additional risk factors that will probably need to start being assessed.”– by Monica Jaramillo
Reference:
Chung CL et al. Evidence-based management of transplant recipients: Transplant skin cancer network. Presented at: American Academy of Dermatology Summer Meeting; July 26-29, 2018; Chicago.
Disclosure: Chung reports no relevant financial disclosures: