title: Cutaneous squamous cell carcinomas in solid organ transplant recipients: emerging strategies for surveillance, staging, and treatment.
abstract: The incidence of cutaneous squamous cell carcinomas (SCCs) in immunosuppressed solid organ transplant recipients (SOTRs) is 65- to 250-fold greater than in the general population. In addition, SCC in SOTRs is more aggressive than in the general population. SOTRs must undergo skin cancer screenings at intervals based on their risk stratification. The incidence of SCC in SOTRs varies with the type, intensity, and duration of the immunosuppressive regimen. Notably, patients on sirolimus have lower incidence of SCC compared to patients on calcineurin inhibitors. Revision of immunosuppressive regimen to include sirolimus may be a viable preventative measure against SCC in SOTRs who are high at risk for developing SCCs. Retinoids are also emerging as a means of chemoprophylaxis against development of new SCCs in high-risk patients. Treatments of SCC include electrodesiccation and curettage, surgical resection, cryosurgery, radiation, and systemic chemotherapy such as 5-fluorouracil and cetuximab.
authors.affiliation: Yale University School of Medicine, New Haven, CT.
authors.forename: Changhyun
authors.initials: C
authors.lastname: Kim
authors.affiliation: Yale University School of Medicine, New Haven, CT.
authors.forename: Joyce
authors.initials: J
authors.lastname: Cheng
authors.affiliation: Yale University School of Medicine, New Haven, CT; Departments of Dermatology and Pathology, Yale University School of Medicine, New Haven, CT; Yale Transplant Dermatology Clinic, Department of Dermatology, Yale University School of Medicine, New Haven, CT; Yale-New Haven Transplantation Center, New Haven, CT; Yale Cancer Center, New Haven, CT. Electronic address: oscar.colegio@yale.edu.
authors.forename: Oscar R
authors.initials: OR
authors.lastname: Colegio
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000517:prevention & control / Q000628:therapy*; D003452:Cryosurgery / Q000379:methods; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008866:Microsurgery / Q000379:methods; D016377:Organ Transplantation / Q000009:adverse effects*; D010778:Photochemotherapy; D011878:Radiotherapy / Q000379:methods; D012176:Retinoids / Q000627:therapeutic use; D021701:Sentinel Lymph Node Biopsy; D020123:Sirolimus / Q000627:therapeutic use; D012878:Skin Neoplasms / Q000473:pathology / Q000517:prevention & control / Q000628:therapy*; D066027:Transplant Recipients
chemical_list: D007166:Immunosuppressive Agents; D012176:Retinoids; D005472:Fluorouracil; D020123:Sirolimus
keywords: Cutaneous squamous cell carcinoma; Management; Solid organ transplant recipients; Surveillance; Treatment