Keratotic skin lesions and other risk factors are associated with skin cancer in organ-transplant recipients: a case-control study in The Netherlands, United Kingdom, Germany, France, and Italy.
This study examines the association of keratotic skin lesions with the development of skin cancer in 915 solid organ-transplant recipients in five European countries. In a hospital-based case-control study, cases with squamous- and basal-cell carcinoma were compared with controls without skin cancer. Questionnaires, scrutiny of medical charts, and skin examination were delivered according to a standardized protocol. Keratotic skin lesions and viral warts were counted on different body sites. Keratotic skin lesions were strongly associated with an increased risk of squamous-cell carcinoma, with adjusted odds ratios of 4.1 (2.4;7.0) and 12.1 (6.1;24) for 1-49 and 50 and more keratotic skin lesions compared with no lesions, respectively. Keratotic skin lesions were also associated with basal-cell carcinoma with adjusted odds ratios of 2.9 (1.7;4.9) and 4.0 (1.7;9.2) for 1-49 and 50 and more lesions, respectively. Lighter skin types and painful sunburns were also significantly associated with an increased risk of squamous- and basal-cell carcinoma. Keratotic skin lesions are strongly associated with skin cancer and are, thus, an important clinical criterion for identifying those organ-transplant recipients at an increased risk of skin cancers who should be offered more intensive skin surveillance.
Bouwes Bavinck
Jan N
JN
Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands. J.N.Bouwes_Bavinck@lumc.nl
Euvrard
Sylvie
S
Naldi
Luigi
L
Nindl
Ingo
I
Proby
Charlotte M
CM
Neale
Rachel
R
Abeni
Damiano
D
Tessari
Gian P
GP
Feltkamp
Mariet C W
MC
Claudy
Alain
A
Stockfleth
Eggert
E
Harwood
Catherine A
CA
D000328:Adult; D000368:Aged; D002280:Basal Cell Carcinoma / Q000453:epidemiology*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D016022:Case-Control Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007642:Keratosis / Q000453:epidemiology* / Q000473:pathology*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology; D012307:Risk Factors; D012727:Sex Characteristics; D012878:Skin Neoplasms / Q000209:etiology*; D012880:Skin Pigmentation; D013472:Sunlight / Q000009:adverse effects; D014180:Transplantation / Q000009:adverse effects*