title: Actinic keratoses, actinic field change and associations with squamous cell carcinoma in renal transplant recipients in Manchester, UK.
abstract: While actinic keratoses (AKs) have a known association with cutaneous squamous cell carcinoma (SCC), the relation of actinic field change to SCC has not been quantified. This study investigated the presence of field change and AKs in renal transplant recipients (RTRs) and estimated SCC risk. In May 2010 to October 2011, a dermatologist examined 452 white RTRs (mean age 53 years) at two hospitals in Manchester, UK, counting AKs and recording field change presence by body site and SCCs arising during the study period. Of the participants 130 (29%) had AKs at examination. In 60 (13%) RTR patients with AKs but no field change, 4 (7%) developed SCCs, compared with 15 (21%) of the 70 (15%) with AKs and field change. SCCs developed directly within field change areas in 11/15 (73%) RTRs. This study confirms that RTRs with widespread confluent actinic skin damage are at very high risk of SCC and should be monitored closely.
authors.affiliation: Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, United Kingdom.
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Wallingford
authors.forename: Sheila A
authors.initials: SA
authors.lastname: Russell
authors.forename: Andy
authors.initials: A
authors.lastname: Vail
authors.forename: Charlotte M
authors.initials: CM
authors.lastname: Proby
authors.forename: John T
authors.initials: JT
authors.lastname: Lear
authors.forename: Adèle C
authors.initials: AC
authors.lastname: Green
mesh_terms: D000293:Adolescent; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D055623:Keratosis, Actinic / Q000453:epidemiology* / Q000473:pathology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology*; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000473:pathology; D013997:Time Factors; D066027:Transplant Recipients; D055815:Young Adult