Beneficial Effect of Low-Dose Systemic Retinoid in Combination With Topical Tretinoin for the Treatment and Prophylaxis of Premalignant and Malignant Skin Lesions in Renal Transplant Recipients

Low-Dose Retinoids in the Prevention of Cutaneous Squamous Cell Carcinomas in Organ Transplant Recipients

“…7 Possible mechanisms by which they prevent or reduce development of skin cancer include induction of growth arrest or apoptosis of tumor cells with resultant inhibition of tumor differentiation and promotion, induction of normal cellular differentiation, and immunomodulation, including increased density of Langerhans cells. [8][9][10] Preferential retinoid-induced growth inhibition of human papillomavirus 16-immortalized keratinocytes compared with noninfected cells 11 may also be relevant, since SCCs from OTRs are associated with a high prevalence of human papillomavirus DNA. 12 Although systemic retinoids have been commonly used for prevention of SCCs in high-risk OTRs, there are surprisingly few clinical studies examining this (reviewed by De Graaf et al 13 ).…”

“…Similar beneficial effects have been documented in a number of uncontrolled series of between 4 and 16 patients treated for less than 6 months to 5 years. 8,10,[14][15][16][17] In the only randomized, placebo-controlled trial, 19 patients received acitretin for 6 months and had significantly fewer SCCs during this time than did 19 placebo-treated patients. 18 Eleven patients completed a randomized crossover trial in which acitretin produced a significant reduction in SCCs compared with no treatment during 12 months.…”

Retinoids: present role and future potential

“…Most of these trials focus on individuals at an increased risk of developing cancer, such as patients with pre-malignant lesions or patients who have been successfully treated for an early-stage carcinoma and have a high risk of developing a second primary cancer. The use of retinoids in patients with cutaneous actinic keratoses results in a significant decrease in the incidence of squamous cell carcinomas of the skin (Moon et al, 1997), and this is also observed in renal transplant patients with this pre-malignant condition (Bavinck et al, 1995;Rook et al, 1995). Similarly, topical ATRA can lead to a clinical and histological improvement in patients with the dysplastic nervous syndrome (Edwards and Jaffe, 1990;Halpern et al, 1994).…”

Dermatologic Problems of Older Women

“…There is histologic evidence supported by clinical pathologic correlation showing the progression of AK to in situ and invasive squamous cell carcinoma (SCC) [31][32][33]. Actinic keratoses may also serve as a marker for people at increased risk for development of malignant melanoma [34]. The cosmetic appearance and rough feel of AKs may be the reason an older patient seeks medical attention; in some cases, the patient perceives the AKs as being dry skin.…”