title: Incidence, risk factors, and preventative management of skin cancers in organ transplant recipients: a review of single- and multicenter retrospective studies from 2006 to 2010.
abstract: BACKGROUND
  Organ transplant recipients (OTRs) taking immunosuppressants are at high risk of skin cancer, which is the most common malignant condition in OTRs, so dermatologic surveillance is important for OTRs.
  
  
  OBJECTIVE
  To characterize the most common skin cancers arising from chronic immunosuppression in OTRs.
  
  
  METHODS
  A PubMed search for retrospective single- and multicenter studies reporting skin cancer incidence from 2006 to 2010 was undertaken. Data regarding each study's immunosuppressive regimen, affected skin cancer cohort, and associated risk factors were extracted.
  
  
  RESULTS
  Thirty-six articles that met our inclusion criteria reported incidences of nonmelanoma skin cancer (NMSC), Kaposi's sarcoma, melanoma, and Merkel cell carcinoma. NMSC was the most commonly reported cancer of all skin cancers after transplantation. Common risk factors were sex, age, sunlight exposure, and immunosuppressive agent-related (duration, type).
  
  
  CONCLUSIONS
  Sun education programs and frequent screenings in organ transplant clinics have provided the best preventative strategies after transplantation, although the characteristics of the immunosuppressive regimen also play an important role. Thus, the adjuvant strategy of modifying immunosuppression may be effective when confronting severe transplant-associated skin cancer. Although the decision-making process for curbing levels of immunosuppression is difficult, further long-term, randomized controlled studies should assess the effect of using less immunosuppressant medication while preserving graft function.
authors.affiliation: Department of Dermatology, Center for Dermatology Research, School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA.
authors.forename: Tejaswi
authors.initials: T
authors.lastname: Mudigonda
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Levender
authors.forename: Jenna L
authors.initials: JL
authors.lastname: O'Neill
authors.forename: Cameron E
authors.initials: CE
authors.lastname: West
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Pearce
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
mesh_terms: D000367:Age Factors; D015266:Carcinoma, Merkel Cell / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D016377:Organ Transplantation; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D012514:Sarcoma, Kaposi / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D012737:Sex Factors; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D013472:Sunlight / Q000009:adverse effects
chemical_list: D007166:Immunosuppressive Agents