Skin Cancer After Organ Transplant (For Professionals)

Skin Cancer After Organ Transplant (For Professionals)

Receiving a kidney or heart transplant nowadays means that survival of 20-30 years survival is quite possible. Organ rejection is no longer a major issue. But this comes at the price of:

• infections
• malignancies

• Example

1. SCC (Squamous Cell Carcinoma) risk is 200 times than in non transplanted individuals. These skin cancers can develop in only weeks, months, and not in many years
2. the risk of metastasis increases to 30% (from 5%).

Why are cancers in immunosuppressed individuals so aggressive ?

• It is known that immunosuppressive drugs alter cell growth.
• UV induces immune suppression and HPV (Human Papillomavirus) is increased in immunosuppression. The cumulative consequence of both is reduction in the mecanisms of cell repair and apoptosis, additionally to direct DNA damage
• The solution is sunscreen usage which increases immune suppression and reduces UV induced damage.

What are other ways of increasing immune surveillance ?

• Imiquimod 5% does just that: increase immune surveillance
• PDT (Photodynamic therapy)
• Topical Diclofenac

Contributors:

Dr Christophe HSU – dermatologist. Geneva, Switzerland

Source of information: Stockfleth E. Skin Cancer in Organ Transplant Recipients. 19th Congress of the European Academy of Dermatology and Venereology (EADV) – Gothenburg (Göteborg), Sweden (Sverige).