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Skin Cancer
Skin Cancer Guide
Transplant Patient Guide
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Types of Skin Cancers



Actinic Keratosis

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

Additional information and photos of actinic keratosis

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(5)


Additional information and photos of Basal Cell Carcinoma

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Squamous Cell Carcinoma:

  • 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
    • 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(6)
    • 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 (7)
    • Pediatric transplant patient have higher risk for Squamous Cell Carcinoma of the lip compared to adult transplant patients
  • Local recurrance rate ~13% in adult transplant patients(8, 9)
  • Metastatic rate ~2% in general population
    • 5-7% in adult organ transplant patients(10)
    • 13% in pediatric organ transplant patients (7)

For additional information and photos of Squamous Cell Carcinoma

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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(1)
    • Melanoma accounts for ~6% of post transplant skin cancers in adult transplant recipients(7)
    • Melanoma accounts for 12-15% of post transplant skin cancers in pediatric organ transplant recipients(7)
    • Transplant recipients with a pre-transplant history of melanoma have a high risk of recurrence (~20%)(11)

For additional information and photos of Melanoma

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Kaposi's Sarcoma

Kaposi's Sarcoma

Kaposi's Sarcoma

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a larger view

  • 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 Kaposi's Sarcoma exist
    • Cutaneous/Mucocutaneous
      • Most common form than occurs in adult transplant patients(12)
      • Most adult cases occur within 1-2 years following transplantation
      • Treatments include reduction in immunosuppression and rapamycin(13)
    • Visceral
      • Most common form that occurs in pediatric transplant patients(7)
      • Most pediatric cases occur while the patient is < 18 years old
      • Kaposi's Sarcoma 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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Anogenital Carcinoma
  • These include tumors of the vulva, scrotum, penis, perianal skin and anus
  • Occur at 30-100 fold higher incidence in transplant patients than the general population
  • Most common in females
    • Ratio of female to male patients 2 to 1 (adult transplant patients)
    • Ratio of female to male patients 8.5 to 1 (pediatric transplant patients)
  • Tend to occur ~12 yrs after transplantation (mean age of 27y/o) in pediatric transplant patients and ~7yrs after transplant in adult transplant recipients
  • Clinically:
    • Tend to be multiple, extensive, or both
    • May resemble wart-like lesions
  • Risk factors include:
    • Mutiple sexual partners, HPV infection, hx of herpes genitalis, heavy smoking, high level of immunosuppression
  • Post-adolescent female transplant recipients should have regular gynecologic examination of the anogenital region

    Numbers in parentheses are references. See the site bibliography.

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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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