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Epidemiology and clinical evolution of non‐melanoma skin cancer in renal transplant recipients: a single‐center experience in São Paulo, Brazil
Author(s) -
Hayashida Marina Zoega,
Fernandes Victor Miguel Coutinho,
Melo Fernandes Diana Rosa,
Ogawa Marília Marufuji,
Tomimori Jane
Publication year - 2015
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/ijd.12632
Subject(s) - medicine , skin cancer , phototype , basal cell carcinoma , epidemiology , dermatology , renal transplant , transplantation , melanoma , retrospective cohort study , cancer , basal cell , cancer research
Background Non‐melanoma skin cancer ( NMSC ) is very common among renal transplant recipients ( RTR s) as a result of the immunosuppressed status of these patients and other factors. Few studies have examined the clinical characteristics and evolution of NMSC in RTR s in tropical countries. Objectives The aim of this study was to characterize the epidemiology and clinical evolution of NMSC in RTR s. Methods We conducted a retrospective study including 68 RTR s with NMSC diagnosed from July 2004 to December 2009 with a minimum follow‐up of three years. We analyzed demographic and transplant‐ and NMSC ‐related data. Results The mean age of patients at the first diagnosis of NMSC was 51 years (range: 29–71 years). Most first diagnoses occurred within nine years post‐transplant. The majority of patients ( n = 48) had Fitzpatrick skin phototype II, although NMSC was also observed in those with skin phototypes III and IV. Forty‐six (67.6%) RTRs had received a kidney from a living donor. Fifty‐five (80.9%) RTRs had received cytotoxic immunosuppressives, 51 (75.0%) had received calcineurin inhibitors, and two (2.9%) had received mTOR inhibitors. Most of the RTRs developed about eight NMSC lesions, but up to 25 NMSC lesions were diagnosed in one patient. Most lesions (67.6%) were located on sun‐exposed areas. Squamous cell carcinoma (SCC) represented the predominant tumor type, accounting for 70.6% of all tumors, whereas basal cell carcinoma accounted for 29.4% of all tumors. Invasive SCC predominated over in situ SCC. Finally, 48.5% of patients had a previous history of viral warts. Conclusions Long‐term use of immunosuppressive therapy increases the risk for tumor occurrence. Multiple NMSC tumors can develop in patients in tropical countries, even in patients with a high skin phototype. Therefore, RTR s should understand the high risk for the development of malignant tumors and should be properly informed about the prevention and treatment of NMSC .