Epidemiology and clinical evolution of non‐melanoma skin cancer in renal transplant recipients: a single‐center experience in São Paulo, Brazil. (13th May 2015)

• Record Type: Journal Article
• Authors: Hayashida, Marina Zoega; Fernandes, Victor Miguel Coutinho; de Melo Fernandes, Diana Rosa; Ogawa, Marília Marufuji; Tomimori, Jane
• Is Part Of: International journal of dermatology. Volume 54:Number 10(2015:Oct.)
• Page Start: e383
• Page End: e388
• Publication Date: 2015-05-13
• Subjects: Dermatology -- Periodicals; 616.5
• DOI: 10.1111/ijd.12632
• Languages: English
• ISSNs: 0011-9059

Abstract

<abstract abstract-type="main" id="ijd12632-abs-0001"> <title>Abstract</title> <sec id="ijd12632-sec-0001" sec-type="section"> <title>Background</title> <p>Non‐melanoma skin cancer (NMSC) is very common among renal transplant recipients (RTRs) as a result of the immunosuppressed status of these patients and other factors. Few studies have examined the clinical characteristics and evolution of NMSC in RTRs in tropical countries.</p> </sec> <sec id="ijd12632-sec-0002" sec-type="section"> <title>Objectives</title> <p>The aim of this study was to characterize the epidemiology and clinical evolution of NMSC in RTRs.</p> </sec> <sec id="ijd12632-sec-0003" sec-type="section"> <title>Methods</title> <p>We conducted a retrospective study including 68 RTRs with NMSC diagnosed from July 2004 to December 2009 with a minimum follow‐up of three years. We analyzed demographic and transplant‐ and NMSC‐related data.</p> </sec> <sec id="ijd12632-sec-0004" sec-type="section"> <title>Results</title> <p>The mean age of patients at the first diagnosis of NMSC was 51 years (range: 29–71 years). Most first diagnoses occurred within nine years post‐transplant. The majority of patients (<italic>n</italic> = 48) had Fitzpatrick skin phototype II, although NMSC was also observed in those with skin phototypes III and IV. Forty‐six (67.6%) RTRs had received a kidney from a living donor. Fifty‐five (80.9%) RTRs had received cytotoxic immunosuppressives, 51 (75.0%) had received calcineurin inhibitors, and two (2.9%) had received mTOR inhibitors. Most of the RTRs developed about eight NMSC lesions, but up to 25 NMSC lesions were diagnosed in one patient. Most lesions (67.6%) were located on sun‐exposed areas. Squamous cell carcinoma (SCC) represented the predominant tumor type, accounting for 70.6% of all tumors, whereas basal cell carcinoma accounted for 29.4% of all tumors. Invasive SCC predominated over <italic>in situ</italic> SCC. Finally, 48.5% of patients had a previous history of viral warts.</p> </sec> <sec id="ijd12632-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Long‐term use of immunosuppressive therapy increases the risk for tumor occurrence. Multiple NMSC tumors can develop in patients in tropical countries, even in patients with a high skin phototype. Therefore, RTRs should understand the high risk for the development of malignant tumors and should be properly informed about the prevention and treatment of NMSC.</p> </sec> </abstract>