title: Resurfacing the back of the hand as treatment and prevention of multiple skin cancers in kidney transplant recipients.
abstract: BACKGROUND
  Skin cancer is a serious problem in renal transplant recipients. In some patients numerous skin cancers develop on the back of the hand. Instead of repeated excisions, a more radical procedure may be necessary. For these patients a new surgical therapy is available: resurfacing the back of the hand.
  
  
  OBJECTIVE
  Our purpose was to clinically evaluate this new procedure.
  
  
  METHODS
  Eleven kidney transplant recipients who underwent resurfacing of the back of the hand were analyzed in a retrospective follow-up study. With this surgical procedure the skin of the entire dorsum of the hand is excised and split-skin grafts harvested from thigh and buttock skin are then placed. Information was gathered from the medical records and questionnaires, and by physical examination.
  
  
  RESULTS
  The mean follow-up time was 4.7 years. No recurrences of skin cancer were observed in the transplanted skin. The cosmetic appearance was acceptable, and there were few side effects.
  
  
  CONCLUSIONS
  Resurfacing the back of the hand can be a successful treatment for carefully selected patients with multiple skin cancers on the back of the hand and can be used prophylactically in patients with severely actinically damaged skin.
authors.affiliation: Department of Dermatology, University Hospital Leiden, The Netherlands.
authors.forename: E J
authors.initials: EJ
authors.lastname: van Zuuren
authors.forename: A N
authors.initials: AN
authors.lastname: Posma
authors.forename: R E
authors.initials: RE
authors.lastname: Scholtens
authors.forename: B J
authors.initials: BJ
authors.lastname: Vermeer
authors.forename: F J
authors.initials: FJ
authors.lastname: van der Woude
authors.forename: J N
authors.initials: JN
authors.lastname: Bouwes Bavinck
mesh_terms: D000328:Adult; D000367:Age Factors; D002294:Carcinoma, Squamous Cell / Q000517:prevention & control* / Q000601:surgery*; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006225:Hand / Q000502:physiology / Q000601:surgery*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D017060:Patient Satisfaction; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000517:prevention & control* / Q000601:surgery*; D016038:Skin Transplantation / Q000009:adverse effects / Q000379:methods; D013997:Time Factors; D014955:Wrist Joint / Q000502:physiology