Funding sources L.J.M. is a recipient of a Medical Research Council Clinical Research Training Fellowship and has received funding from the Chief Scientists Office Scotland.
EPIDEMIOLOGY AND HEALTH SERVICES RESEARCH
Skin tumours in the West of Scotland renal transplant population
Article first published online: 25 APR 2013
© 2012 The Authors. BJD © 2012 British Association of Dermatologists
British Journal of Dermatology
Volume 168, Issue 5, pages 1047–1053, May 2013
How to Cite
Mackintosh, L.J., Geddes, C.C. and Herd, R.M. (2013), Skin tumours in the West of Scotland renal transplant population. British Journal of Dermatology, 168: 1047–1053. doi: 10.1111/bjd.12129
Conflict of interests None declared.
- Issue published online: 25 APR 2013
- Article first published online: 25 APR 2013
- Accepted manuscript online: 8 NOV 2012 10:41AM EST
- Accepted for publication 1 November 2012
Background Organ transplant recipients have an increased risk of skin cancers. A specialist dermatology clinic for renal transplant recipients (RTRs) was established in 2005.
Objectives To analyse the type and incidence of skin cancers in prevalent patients in the West of Scotland after renal transplant, and to analyse the impact of the time since transplant and the immunosuppression regimen.
Methods Skin cancer data for RTRs attending the transplant dermatology clinic over a 38-month period were collected and recorded in the West of Scotland electronic renal patient record. Skin cancer data were intrinsically linked to each individual’s transplant and immunosuppression data.
Results Overall, 610 patients attended. The median follow-up time from the date of first transplant was 10 years. Ninety-three patients (15·2%) had experienced a total of 368 skin cancers since transplant, and the prevalence increased with time since transplant. Basal cell carcinomas (BCCs) occurred in 74 patients (12·1%) and squamous cell carcinomas (SCCs) in 42 patients (6·9%). Three patients (0·5%) had experienced a melanoma. The SCC:BCC ratio was 0·7. Survival analysis showed significant reduction in the time to develop skin cancer in patients transplanted from 1995 onwards (P < 0·0001) and in patients who had been on triple immunosuppressant therapy at 1 year after transplant, compared with dual therapy (P < 0·0001).
Conclusions This is the first study of skin cancer in prevalent Scottish RTRs. The incidence of skin cancer is high and appears to have a direct relationship to the overall burden of immunosuppression. The SCC:BCC ratio, which is lower than reports from other centres, deserves further scrutiny.