Cic edizioni internazionali
Clinical Dermatology

A protocol for skin cancer screening for solid organ transplant recipients based on a single-centre retrospective series in South Australia

Original Article, 87 - 92
doi: 10.11138/cderm/2016.4.3.087
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Abstract
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Long-term survival after organ transplantation is increasing and as a result, health practitioners across multiple disciplines are encountering more patients with complications of transplantation. Immunosuppressive treatment is associated with an increased risk of various cancers, including skin cancers. Regular outpatient dermatological review of solid organ transplant recipients (SOTRs) is routine in South Australia, however at present, no data exists to outline the frequency of review required in a tertiary setting for these patients. We carried out a single-centre retrospective series to examine which transplant recipients were at highest risk of developing skin cancer and at what point in time post transplant. The clinical outcome was to identify a set of patient criteria and recommend a time-effective protocol for dermatology outpatient skin cancer surveillance of SOTRs. Our results support increasing age, time since transplant and male gender as risk factors for the development of skin cancer post solid organ transplantation. Our series did not identify any risk factors for multiple skin cancers, but it did demonstrate that in our SOTR population, nearly 2/3 of those who develop one skin cancer will develop at least a second. Our results also demonstrate over half of second skin cancers occur by 1 year and nearly all within 3 years from the first skin cancer detection. Our results are consistent with a number of larger publications. This study provides evidence to support the current practice of annual full skin examination of all patients following transplantation for the first 8 years post transplantation.
Once a skin cancer is detected, follow up every 6-12 months would be an appropriate initial practice, and increased to 3-6 monthly after a second skin cancer occurs.
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