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Skin Cancer
Skin Cancer Guide
Transplant Patient Guide
Caring for Transplant Patients
Seminars
Organ Transplant Immunosuppressed High Risk Skin Cancer Clinic
Tumor Board
Mohs Surgery
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Types of Skin Cancer

Actinic Keratosis: Precursor to Squamous Cell Carcinoma

  • Rough, red or pink scaly patches on sun-exposed areas of the skin,usually <0.5cm in diameter
  • Precurser lesion for squamous cell carcinoma (Squamous Cell Carcinoma)
  • Up to 1% of these lesions can develop into a Squamous Cell Carcinoma

See actinic keratosis photos and patient information

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Basal Cell Carcinoma :

  • Raised, pink, waxy bumps that may bleed following minor injury
  • May have superficial blood vessels and a central depression
  • Locally invasive
  • Rarely metastasizes
  • Organ transplant recipients have a 10-fold higher risk for Basal Cell Carcinoma compared to the general population(2)

See basal cell carcinoma photos and patient information.

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Melanoma:

  • Neoplasm of pigment (melanin) producing cells
  • Brown or black skin lesion with irregularities in symmetry, border and coloration
  • Prognosis dependent on depth of invasion
  • ~100,000 new cases of melanoma are diagnosed in the United States each year
    • Only 4% of diagnosed skin cancer, but 77% of skin cancer related deaths
  • Organ transplant recipients have a 3 to 4-fold higher risk for melanoma compared to general population(12)
    • Melanoma accounts for ~6% of post transplant skin cancers in adult transplant recipients(13)
    • Melanoma accounts for 12-15% of post transplant skin cancers in pediatric organ transplant recipients(13)
    • Transplant recipients with a pre-transplant history of melanoma have a high risk of recurrence (~20%)(14)

See melanoma photos and patient information.

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Kaposi's Sarcoma

Kaposi's Sarcoma

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a larger view

Kaposi's Sarcoma (KS):

  • Rare, cancer of the cells that line blood vessels (endothelial cells)
  • Clinically: brownish-red to blue colored skin lesions found most frequently on legs and feet
  • Caused by Human Herpes Virus 8 (HHV-8) which causes the cells that line blood vessels (endothelial cells) to become cancerous in the setting of profound and prolonged immunosuppression
    • Typically occurs in patients of Middle Eastern, Jewish, Mediterranean or African descent where HHV-8 in endemic
  • Two main forms of KS exist
    • Cutaneous/Mucocutaneous
      • Most common form than occurs in adult transplant patients(1)
      • Most adult cases occur within 1-2 years following transplantation
      • Treatments include reduction in immunosuppression and rapamycin(15)
    • Visceral
      • Most common form that occurs in pediatric transplant patients(13)
      • Most pediatric cases occur while the patient is < 18 years old
      • KS tumors can affect the gastrointestinal system, lymph nodes and lungs
      • The visceral form is considered more serious than the cutaneous/mucocutaneous form

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Squamous Cell Carcinoma:

  • Most common skin cancer affecting transplant patientss
  • Dull red, rough, scaly raised skin lesions
  • Occur most frequently on sun exposed areas (head, neck, ears, lips, back of the hands and forearms)
    • Sites particularly associated with elevated risk for recurrence or metastasis include: ear, lip/perioral, nose, periorbital, genitalia
  • Most common skin cancer that occurs in pediatric and adult transplant recipients
    • Ratio of Squamous Cell Carcinoma:Basal Cell Carcinoma = 3:1, opposite to the general population
    • Squamous Cell Carcinoma tumors can grow very rapidly
    • Mutiple cancers can occur simultaneously
    • Squamous Cell Carcinoma tends to be more invasive and more aggressive in transplant patients
  • Organ transplant recipients have a 65-fold higher risk for Squamous Cell Carcinoma and 20-fold higher risk for Squamous Cell Carcinoma of the lip compared to the general population(16)
    • Adult transplant patients tend to develop Squamous Cell Carcinoma 5-7 years following transplant
    • Pediatric transplant patients (patients who received their transplants before the age of 18) tend to develop Squamous Cell Carcinoma an average of 10 years following transplant (13)
    • Pediatric transplant patient have higher risk for Squamous Cell Carcinoma of the lip compared to adult transplant patients
  • Local recurrence rate ~13% in adult transplant patients(17, 18)
  • Metastatic rate ~2% in general population
    • 5-7% in adult organ transplant patients(19)
    • 13% in pediatric organ transplant patients (13)

Current Guidelines suggest Squamous Cell Carcinoma be risk stratified. Read more about these guidelines.

See Squamous Cell Carcinoma photos and patient information.

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Updated: May 4, 2007
This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.
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