Racial Differences in Rates of Malignant and Infectious Cutaneous Genital Disease after Solid Organ Transplantation
1Department of Dermatology, Drexel University, Philadelphia, PA
2Department of Internal Medicine, University of Virginia, Charlottesville, VA.
Meeting: 2018 American Transplant Congress
Abstract number: A318
Keywords: Immunosuppression, Kidney/liver transplantation, Post-transplant malignancy, Risk factors
Session Information
Session Name: Poster Session A: Non-Organ Specific: Disparities to Outcome and Access to Healthcare
Session Type: Poster Session
Date: Saturday, June 2, 2018
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall 4EF
Purpose: To describe the prevalence and types of genital lesions observed in OTRs
Methods: This retrospective review included 496 OTRs who underwent full skin examination at Drexel Dermatology Center for Transplant Patients from November 1, 2011 to April 28, 2017 at an academic referral center. Patient awareness of genital lesions was assessed. All genital lesions clinically suspicious for malignancy were biopsied. All histologically-confirmed skin cancers were sent for HPV DNA PCR typing. The main outcomes of the review were number and types of genital lesions in the OTR cohort, proportion of malignancies positive for HPV, and proportion of patients cognizant of lesions in the genital area.
Results: Overall, 93% (N=111) of OTRs denied the presence of genital lesions during the history taking portion of the medical examination. In our cohort, the overall prevalence of genital lesions was 44% (N=53), cutaneous malignancy was 5.0%, genital SCCIS was 4.17%, and CA was 27%. Eight (67%) of the 12 SCCIS lesions were positive for high-risk HPV. Seven tested positive for HPV types 16/18 and one tested positive for high-risk HPV DNA but could not be further specified.
Conclusions and Relevance: Genital lesions, including condyloma and skin cancer, in OTRs are common but awareness is low. Nonwhite OTRs, in particular black OTRs, are disproportionately affected by cutaneous genital malignancy. High-risk HPV subtypes are closely associated with genital SCC in OTRs. All OTRs should undergo thorough inspection of genital skin as a part of routine posttransplant skin examinations and be counseled to include genitalia during self skin examinations. Patients with darker skin types, particularly nonwhite males, should not have screening delayed post transplant but rather undergo a targeted program of early detection, prevention, and awareness focused on the risk for genital skin cancer. Further studies are warranted to determine the incidence of and identify significant risk factors in the development of cutaneous genital malignancy and to assess the utility of pre-transplant HPV vaccination in the prevention of cutaneous genital malignancy.
CITATION INFORMATION: Larijani M., Nadhan K., Abbott J., Doyle A., Chung C. Racial Differences in Rates of Malignant and Infectious Cutaneous Genital Disease after Solid Organ Transplantation Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Larijani M, Nadhan K, Abbott J, Doyle A, Chung C. Racial Differences in Rates of Malignant and Infectious Cutaneous Genital Disease after Solid Organ Transplantation [abstract]. https://atcmeetingabstracts.com/abstract/racial-differences-in-rates-of-malignant-and-infectious-cutaneous-genital-disease-after-solid-organ-transplantation/. Accessed May 16, 2025.« Back to 2018 American Transplant Congress