Background: It has been well documented that patients who have undergone organ transplantation have a higher incidence of new skin cancers and that this risk magnifies over time and continued exposure to immunosuppression. Herein, we report on our first year experience with a new transplant dermatology clinic and argue for the coordination of dermatologic care for transplant patients.
Methods: We retrospectively examined all newly referred transplant patients seen in the first 12 months of clinic operation. During their initial consultation patients were evaluated for all cutaneous lesions.
Results: A total of 100 newly referred transplant patients were evaluated including 58 men and 42 women (mean age 52 years). Most of the patients had received a kidney transplant (83%) although a wide variety of organs and combinations were seen. Among the 100 patients there were 40 distinct dermatologic diagnoses excluding nevi and lentigines. These included 22% who had either a malignant (13%) or a pre-malignant (9%) diagnosis. 5/100 patients (5) were diagnosed with basal cell carcinoma (BCC), 2/100 patients (2%) were diagnosed with squamous cell carcinoma (SCC) or squamous cell carcinoma in-situ (SCCIS), and 6/100 patients (6%) were diagnosed with both BCC and SCC/SCCIS. No melanomas were identified. Pre-malignant diagnoses included actinic keratosis (AK) (8/100), porokeratosis (3/100), and atypical intraepidermal melanocytic proliferation (1/100). Of the 13 patients with skin cancer, only 2 reported a known history of skin cancer, one of which was diagnosed with 2 additional skin cancers.
Conclusion: We believe that specialized transplant dermatology should be considered an essential part of transplant care. During the first year of operation of a specialized medical-surgical dermatology transplant center we found a large number of previously undiagnosed serious dermatologic conditions including 22% of patients with either malignant or pre-malignant lesions– all of which were able to be treated successfully at an early stage. In addition, each patient underwent an intensive, targeted education program to help reduce future risk.
To cite this abstract in AMA style:Abdelmalek M, Chung C, Pritchett E, Nijhawan R, Condon S, Guy S, Malat G, Ranganna K, Doyle A. Transplant Dermatology Is an Essential Part of Transplant Care: Report of First Year Experience [abstract]. Am J Transplant. 2013; 13 (suppl 5). http://atcmeetingabstracts.com/abstract/transplant-dermatology-is-an-essential-part-of-transplant-care-report-of-first-year-experience/. Accessed January 17, 2018.
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