Introduction:

It is predicted by the US census that by year 2050, minorities will become the majority US population. We know skin cancer in patients with skin of color to be associated with greater morbidity and mortality due largely to diagnosis and treatment delay. We also know the immunosuppressed population has a much higher risk of non-melanoma skin cancer than those with an intact immune system. Given these statements, patients that are potentially at even higher risk include the subset of patients that have both skin of color and are immunosuppressed. Very little is known of the risk for skin cancer in the population that is both immunosuppressed and has skin of color. We seek to add to the epidemiological data regarding skin cancer in the immunosuppressed minority population.

Methods:

A retrospective chart analysis of biopsies performed from 2008 to the present was reviewed. Those patients with a diagnosis of non-melanoma skin cancers that were non-white and also immunosuppressed organ transplant recipients were included as the study population. Additional characteristics such as type of skin cancer and health background of the patient were then obtained for further evaluation.

Results:

From 2008-2015, there were 16 biopsies of patients with a diagnosis of non-melanoma skin cancer in the immunosuppressed skin of color organ transplant recipient population. These represent 8 African American patients, 3 Hispanic patients, and 5 Asian patients. A diagnosis of squamous cell carcinoma in-situ was highly represented across all races comprising 11 of 16 biopsies. Furthermore, 73% were located on either the hands or genital region.

Conclusion:

We obtained 16 biopsies of patients with non-melanoma skin cancer who were also immunosuppressed transplant minorities. A large proportion of their skin cancer diagnoses were squamous cell carcinoma in-situ and were furthermore mostly located on the hands and genitals. This finding emphasizes the need to screen all high-risk minorities who are immunosuppressed for the possibility of skin cancer. Furthermore, a special emphasis needs to be placed on evaluation of the hands and genitals. Additionally, HPV status and other potential risk factors need to be elucidated. Finally, emphasis should be placed on periodic skin cancer screening and guidelines regarding HPV vaccination in the transplant population need to be addressed.

CITATION INFORMATION: Shaver C, Cusack C, Chung C. An Epidemiological Update of Non-Melanoma Skin Cancer in Immunosuppressed Organ Transplant Recipients with Skin of Color. Am J Transplant. 2016;16 (suppl 3).

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