Patient Information

SKIN CARE ADVICE FOR ORGAN TRANSPLANT PATIENTS

Organ transplant patients life expectancy is increasing steadily but there is a higher risk of developing skin cancer as compared to non transplant population. Most skin cancers could be avoided by observing certain rules of life. This document provides information on the importance of detection and early treatment of skin cancers and on the way to decrease this risk.

WHY TRANSPLANT PATIENTS ARE AT A HIGHER RISK OF SKIN CANCER ?

Immunosuppressive treatments decrease the capacity of the organism's defence mechanisms to prevent the rejection of grafted organs. However, these treatments increase the risk of skin cancer and also of other benign tumours and infections.

HOW TO IDENTIFY SKIN CANCER ?

Skin cancers are the most frequent cancers. Premalignant conditions may precede the development of skin cancers. These are actinic keratoses.

Actinic keratose

They may change into invasive cancer: these are pink or red or brown spots with an irregular surface (figure 1). They are localised on light exposed areas. They are often easier to touch than to see. Early treatment of actinic keratoses may prevent their change to cancer.

Basal cell carcinoma

This type of cancer usually presents as a pinkish small tumour on the head or the neck. However there are a few forms that might be confused with scars – the sclerodermiform basal cell carcinoma. If not treated, it may change to ulceration, bleeding, and formation of crust. Basal cell carcinoma increases slowly and rarely spreads to other parts of the body invading muscle and bones.

Squamous cell carcinoma

This is the most frequent cancer in organ transplant patients. Its appearance may be close to the one of basal cell carcinoma but its relief is generally higher and crustier. It may look like an irritated wart (Fig 2). It occurs most often on the head, neck, ears, lips, back of the hands and forearms. This tumour may spread to lymphatic nodes and other organs (metastases). Squamous cell carcinoma may be easily cured if treated early.

Melanoma

Melanoma presents usually as a brown or black spot and it may also come from the change of a previous mole.

WHAT IS THE OCCURRENCE RATE OF SKIN CANCER ?

Most transplant patients may develop skin cancer at a moment or another. The delay after transplantation is on average 7 years, but it may be extremely variable according to individual factors. The risk of developing skin cancer increases with time and twenty years after transplantation, about half of patients have been concerned.

ALL TRANSPLANT PATIENTS ARE AT RISK

All transplant patients, whatever their skin type may develop skin cancer. However, transplant patients with the following characteristics are at a higher risk than others.

Fair skin type burning easily
Light coloured eyes, blue grey or hazel
Blond or red hair
Numerous freckles
Outdoor work or history of heavy sun exposure
History of skin cancer

Your dermatologist should regularly examine all your skin (at least once a year) even if your self examination seems normal to you.

MOST SKIN CANCERS COULD BE AVOIDED. THE MOST IMPORTANT IS THE REGULAR EXAMINATION OF YOUR SKIN AND SUN PROTECTION.

IF YOU WANT TO LEARN MORE ABOUT SKIN CANCER PREVENTION PLEASE GO TO THE PROPYLAXIS PAGE

These recommendations have been written by the dermatologists of the group «skin and organ transplantation », from the French Society of Dermatology and have been modified for the European SCOP Information device.