De Novo Skin Neoplasms in Liver-Transplanted Patients: Single-Center Prospective Evaluation of 105 Cases

Abstract

Background and Objectives: Solid-organ transplant recipients (SOTRs) are notably considered at risk for developing cutaneous malignancies. However, most of the existing literature is focused on kidney transplant-related non-melanoma skin cancers (NMSCs). Conflicting data have been published so far on NMSC incidence among liver transplant recipients (LTRs), and whether LTRs really should be considered at lower risk remains controversial. The aim of the present study was to prospectively collect data on the incidence of cutaneous neoplasms in an LTR cohort. Materials and Methods: All LTRs transplanted at the Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit of Modena University Hospital from October 2015 to June 2021 underwent a post-transplant periodic skin check at the Dermatology Unit according to our institutional integrated care pathway. Data on the presence of cutaneous malignant and premalignant lesions were collected at every timepoint. Results: A total of 105 patients were enrolled in the present study. Nearly 15% of the patients developed cutaneous cancerous and/or precancerous lesions during the follow-up period. Almost half of the skin cancerous lesions were basal cell carcinomas. Actinic keratoses (AKs) were observed in six patients. Four patients developed in situ squamous cell carcinomas, and one patient was diagnosed with stage I malignant melanoma. Otherwise, well-established risk factors for the occurrence of skin tumors, such as skin phototype, cumulative sun exposure, and familial history of cutaneous neoplasms, seemed to have no direct impact on skin cancer occurrence in our cohort, as well as an immunosuppressive regimen and the occurrence of non-cutaneous neoplasms. Conclusions: Close dermatological follow-up is crucial for LTRs, and shared protocols of regular skin checks in this particular subset of patients are needed in transplant centers.

Early Results of a Screening Program for Skin Cancer in Liver Transplant Recipients: A Cohort Study

“…Skin cancer trends differ among liver transplant recipients compared to other SOT recipients [ 22 , 23 ]. Prior studies specifically addressing skin cancer incidence in liver transplant recipients support the herein reported BCC:SCC ratio [ 20 , 21 , 30 ]. Further investigation is needed to determine if this pattern is specific to liver transplant recipients or influenced by the high screening attendance in our cohort, possibly indicating a protective effect through the regular detection and treatment of preneoplastic lesions and patient education.…”

“…Adherence to regular dermatological assessment is reported to reduce the rates of advanced skin cancer in SOT recipients [ 11 , 12 ]. However, studies reporting on the incidence and risk factors of skin cancer in liver transplant recipients enrolled in a skin cancer screening program are sparse [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. Due to significant variations in skin cancer risk among different SOT groups, it is essential to investigate the risk within distinct subpopulations [ 22 , 23 ].…”