title: Skin tumours in the West of Scotland renal transplant population.
abstract: BACKGROUND
  Organ transplant recipients have an increased risk of skin cancers. A specialist dermatology clinic for renal transplant recipients (RTRs) was established in 2005.
  
  
  OBJECTIVE
  To analyse the type and incidence of skin cancers in prevalent patients in the West of Scotland after renal transplant, and to analyse the impact of the time since transplant and the immunosuppression regimen.
  
  
  METHODS
  Skin cancer data for RTRs attending the transplant dermatology clinic over a 38-month period were collected and recorded in the West of Scotland electronic renal patient record. Skin cancer data were intrinsically linked to each individual's transplant and immunosuppression data.
  
  
  RESULTS
  Overall, 610 patients attended. The median follow-up time from the date of first transplant was 10 years. Ninety-three patients (15.2%) had experienced a total of 368 skin cancers since transplant, and the prevalence increased with time since transplant. Basal cell carcinomas (BCCs) occurred in 74 patients (12.1%) and squamous cell carcinomas (SCCs) in 42 patients (6.9%). Three patients (0.5%) had experienced a melanoma. The SCC:BCC ratio was 0.7. Survival analysis showed significant reduction in the time to develop skin cancer in patients transplanted from 1995 onwards (P < 0.0001) and in patients who had been on triple immunosuppressant therapy at 1 year after transplant, compared with dual therapy (P < 0.0001).
  
  
  CONCLUSIONS
  This is the first study of skin cancer in prevalent Scottish RTRs. The incidence of skin cancer is high and appears to have a direct relationship to the overall burden of immunosuppression. The SCC:BCC ratio, which is lower than reports from other centres, deserves further scrutiny.
authors.affiliation: The Alan Lyell Centre for Dermatology, Western Infirmary, Glasgow, UK. lornamackintosh@hotmail.com
authors.forename: L J
authors.initials: LJ
authors.lastname: Mackintosh
authors.forename: C C
authors.initials: CC
authors.lastname: Geddes
authors.forename: R M
authors.initials: RM
authors.lastname: Herd
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000209:etiology*; D002294:Carcinoma, Squamous Cell / Q000209:etiology*; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation; D008297:Male; D008545:Melanoma / Q000209:etiology*; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D012878:Skin Neoplasms / Q000209:etiology*; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents