Incidence of and Risk Factors for Skin Cancer After Heart Transplant

Brewer, Jerry D.; Colegio, Oscar R.; Phillips, P. Kim; Roenigk, Randall K.; Jacobs, M. Amanda; Beek, Diederik van de; Dierkhising, Ross A.; Kremers, Walter K.; McGregor, Christopher G.A.; Otley, Clark C.

doi:10.1001/archdermatol.2009.276

Cited by 107 publications

(78 citation statements)

References 23 publications

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“…The number of primary tumors and extent of metastatic disease varied greatly between patients and skin cancer type. SCC was the most common metastatic skin cancer in our patients, which is consistent with the literature 5 . The primary SCCs in our population were mostly moderately or poorly-differentiated with perineural invasion, suggesting an aggressive carcinoma.…”

Section: Discussionsupporting

confidence: 93%

“…Unlike the non-immunosuppressed population, SOTRs are more likely to develop SCC than BCC. A study 5 in heart transplant recipients found that 89% of skin cancers in this population were SCC, while 11% were BCC. The prevailing theory for skin cancer development in SOTRs is that due to diminished immune surveillance, an enhancement of UVinduced DNA damage allows atypical cells to survive and proliferate 6,7 .…”

Section: Introductionmentioning

confidence: 83%

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Clinical Findings, Treatments and Outcomes of Transplant Recipients with Metastatic Skin Cancer

2017

ARC Journal of Dermatology

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 83%

Clinical Findings, Treatments and Outcomes of Transplant Recipients with Metastatic Skin Cancer

2017

ARC Journal of Dermatology

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“…Th e pathophysiology of IBD-related osteoporosis is multifactorial; however, risk cancer. Th e risk of metachronous lesions in patients with one prior BCC or SCC has been demonstrated to be high in heart transplant patients with 60-70% developing a subsequent SCC within 5 years ( 128,133 ). When cutaneous SCCs develop in patients with transplants who are receiving immunosuppressive therapy the tumors seem to be more aggressive than those patients not receiving immunosuppressive therapy.…”

Section: Summary Of Evidencementioning

confidence: 99%

ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease

Farraye

Melmed

Lichtenstein

et al. 2017

American Journal of Gastroenterology

403

421

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Recent data suggest that infl ammatory bowel disease (IBD) patients do not receive preventive services at the same rate as general medical patients. Patients with IBD often consider their gastroenterologist to be the primary provider of care. To improve the care delivered to IBD patients, health maintenance issues need to be co-managed by both the gastroenterologist and primary care team. Gastroenterologists need to explicitly inform the primary care provider of the unique needs of the IBD patient, especially those on immunomodulators and biologics or being considered for such therapy. In particular, documentation of up to date vaccinations are crucial as IBD patients are often treated with long-term immune-suppressive therapies and may be at increased risk for infections, many of which are preventable with vaccinations. Health maintenance issues addressed in this guideline include identifi cation, safety and appropriate timing of vaccinations, screening for osteoporosis, cervical cancer, melanoma and non-melanoma skin cancer as well as identifi cation of depression and anxiety and smoking cessation. To accomplish these health maintenance goals, coordination between the primary care provider, gastroenterology team and other specialists is necessary. of evidence, we entered data from the papers of highest evidence into the GRADE program (accessible at http://www.gradepro.org ). Th e recommendation statements from this guideline are shown in Table 1 . Summary statements, when listed, are designed to be descriptive in nature without associated evidence-based ratings. VACCINATIONSRecent data suggest that IBD patients do not receive preventive services at the same rate as general medical patients ( 2 ). Members of the gastroenterology team are oft en the only clinicians that a patient with IBD will see. As such, it is incumbent upon gastroenterologists to take a proactive role in the health care needs of their IBD patients ( 3-5 ). It is crucial to clarify with the patient the limits of the specialist's responsibilities and delegate routine health care issues to the primary care clinician. It is equally important to educate the primary care clinician to the unique health maintenance needs of the IBD patient, especially those on immunomodulators and biologic agents. Although it appears that both primary care clinicians and gastroenterologists are hesitant to take ownership of vaccinations ( 6-8 ), it is reasonable ( 9 ) that vaccination recommendations be the responsibility of the treating gastroenterologist, but the actual delivery/administration of these vaccines may be a shared responsibility ( 10-13 ). Communicating specifi c recommendations to the primary care team in a concise fashion are needed. Consider empowering the patient by giving written recommendations to bring to their primary care physician. Clinicians sharing an electronic medical record should use this platform to send recommendations to the referring clinician.Patients with IBD are oft en treated with long-term immunesuppressive therapies and may t...

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“…Most of the cutaneous malignancies, primarily diagnosed on the sun-exposed skin of OTRs, are NMSC, with SCC and BCC accounting for more than 90% of the total. [19][20][21] An increased incidence of skin cancer has also been observed in diseases such as inflammatory bowel disease, where active immunosuppressive agents similar to those in OTRs are used. 22,23 Against this background, it becomes very obvious that adequate photoprotection is the key to reducing the harmful effects of UVR.…”

Section: Discussionmentioning

confidence: 99%

Photoprotection in immunocompetent and immunocompromised people

Surber

Ulrich

Hinrichs³

et al. 2012

British Journal of Dermatology

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SummaryUltraviolet radiation (UVR) exposure from the sun and artificial UV sources has been widely acknowledged as the major culprit for skin cancer and premature skin ageing. Skin cancers are among the most dangerous (cutaneous malignant melanoma) and the most numerous (basal cell carcinoma, actinic keratosis and invasive squamous cell carcinoma) of all neoplasms in the caucasian population worldwide. Skin cancers therefore have a significant impact on public health and healthcare costs, and will continue to do so. It is obvious that adequate photoprotection -seeking shade, wearing protective clothing and using sunscreens -is the key to reducing the harmful effects of UVR in both immunocompetent and immunocompromised people. This article provides background information on UVR, photoprotection (including the concept of topical sunscreen formulations), associated concerns regarding efficacy and safety, and behavioural and educational aspects of photoprotection and skin cancer prevention in immunocompetent and immunocompromised people. Certain persistent misconceptions and mistakes regarding photoprotection are also addressed.Ultraviolet radiation (UVR) exposure from the sun and artificial UV sources has been widely acknowledged as the major culprit for skin cancer and premature skin ageing.

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Incidence of and Risk Factors for Skin Cancer After Heart Transplant

Cited by 107 publications

References 23 publications

Clinical Findings, Treatments and Outcomes of Transplant Recipients with Metastatic Skin Cancer

Clinical Findings, Treatments and Outcomes of Transplant Recipients with Metastatic Skin Cancer

ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease

Photoprotection in immunocompetent and immunocompromised people

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