Organ transplantation and cutaneous squamous cell carcinoma: progress, pitfalls and priorities in immunosuppression‐associated keratinocyte carcinoma

Abstract

Linked Articles: Madeleine et al. Br J Dermatol 2017; 177:1208–1216. Harwood et al. Br J Dermatol 2017; 177:1217–1224. Lowenstein et al. Br J Dermatol 2017; 177:1202–1207. Blomberg et al. Br J Dermatol 2017; 177:1225–1233.

European interdisciplinary guideline on invasive squamous cell carcinoma of the skin: Part 1. epidemiology, diagnostics and prevention

“…While most cSCCs will arise in the context of AKs and in patients with chronic photoaging, the rate of transformation of clinically evident AKs into cSCC is very low, at least in a few years period of follow-up (less than 1/1000 per year during a 5-year follow up) [52e54]. Available evidence indicates that incidence rates are consistently highest in fair-skinned populations in geographic locations with high ambient UV exposure; are higher among men than women; increase markedly with age e 80% occur in people over 60, probably because of the driving role of cumulative sun exposure, which increases with age; increase with decreasing deprivation; are more common and have worse prognosis with immunosuppression [17,19,24,25,55].…”

Sex Disparity for Patients with Cutaneous Squamous Cell Carcinoma of the Head and Neck: A Systematic Review

“…Evidence for a role for the immune regulated resistance to cancer development and progression is most prominent in the study of cSCC in immune suppressed organ transplant recipients [ 100 ]. Cancer rates in organ transplant recipients are generally higher, and this rate is between 60–100 times greater than the age-matched population for cSCC.…”

Cutaneous Squamous Cell Carcinoma Arising in Immunosuppressed Patients: A Systematic Review of Tumor Profiling Studies

“…These mutations may also be present in the OTR population, but the prevalence of these mutations in the OTR population remains to be elucidated. In addition, gene mutations may be influenced by immunosuppressive therapies used to prevent transplant rejection, which may lead to varying mutational signatures even among OTRs ( Harwood et al., 2017 ). cSCC occurring in patients on azathioprine (AZA), for example, are more likely to have the classic mutational signature of NOTCH1/2/4 , CDKN2A , and P53 , as described above, than patients on other immunosuppressants ( Inman et al., 2018 ).…”