Transplant Dermatology

Faculty: Lindsay S. Ackerman, MD

Thursday morning at the SDPA Fall Conference began with an enlightening lecture on skin cancer in solid organ transplant patients.

Dr. Lindsay Ackerman described the solid organ transplant patient as the “most vulnerable population” for morbidity and mortality from the skin cancer epidemic. For example, transplant patients have a 65-fold increased risk for the development of squamous cell cancer (SCC). Dr. Ackerman reported SCC should “almost be considered a different type of malignancy” in these patients due to its aggressive behavior. In transplant patients, there is a regional and distant metastatic rate of up to 8% for SCC. Additionally, up to 27% of deaths are attributed to skin cancer for post-transplant patients 4 years out. Dr. Ackerman also discussed the 10-fold increased risk of basal cell cancers (BCC) in the transplant population with liver transplant patients at the highest risk for the development of BCC.

Dr. Lindsay Ackerman described the solid organ transplant patient as the “most vulnerable population” for morbidity and mortality from the skin cancer epidemic.

In addition to non-melanoma skin cancers, transplant patients have an increased risk for the development of melanoma. Of note , African Americans (AA) with a kidney transplant have a much higher risk (17.2x) for the development of melanoma compared with AA patients without a history of transplantation. Dr. Ackerman went on to discuss the presentation of skin cancer in pediatric transplant patients. The fungal medication, Voriconazole, is a photosensitizing agent, and significantly increases the risk for patients to develop skin cancer, at a rate of 43%. Additional discussion included HPV, education of the transplant patient, prevention and changing immunosuppression protocols.