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Skin of colour organ transplant recipients at higher risk of skin cancer post-transplantation

Non-Caucasian organ transplant recipients face an increased risk of developing skin cancer post-transplantation, according to findings from a study published online in JAMA Dermatology (Sept. 21, 2016).

This research looked at a diverse population of non-Caucasian transplant recipients to determine the prevalence of cancerous lesions, said the study’s principal investigator Dr. Christina Lee Chung.

“Overall, people tend to believe that dark-skinned patients can’t get skin cancer,” said Dr. Christina Lee Chung associate professor in the Department of Dermatology at Drexel University in Philadelphia, Penn. She is also the director at Drexel Dermatology Center for Transplant Patients.

“But they are taking the same immunosuppressant drugs as their [Caucasian] counterparts,” added Dr. Chung, who was quoted in a press release.

During the investigation, the researchers conducted a retrospective medical record review of 413 organ transplant recipients consisting of 154 Caucasian patients and 259 non-Caucasian patients—African American, Asian, Hispanic and Pacific Islander.

The findings revealed that out of 259 non-Caucasian transplant recipients who were included in this study, 19 cancerous lesions were identified in 6% of the patients (African American (n=6), Asian (n=5) and Hispanic (n=4).

HPV and squamous-cell carcinoma risk

In addition, data showed that the majority of skin cancers in African American transplant patients were found in the groin-genital area and most of those lesions tested positive for high-risk human papillomavirus (HPV). Most skin cancers in Asians were located on sun-exposed areas and occurred in individuals who emigrated from equatorial locations.

The potential association between HPV and squamous-cell carcinoma warrants careful examination of the groin, genitalia and perianal area in search of early lesions, the study authors write.

Researchers added that the findings also suggests there may be significant differences in risk factors pertaining to the development of skin cancer between white and black organ transplant recipients.

Study takeaway message

“If you’re spending all of your time counselling your [African American] patients about sunscreen, you’re probably missing more important aspects of skin cancer prevention,” Dr. Chung said.

Instead, she added, consideration should be given to administering the HPV vaccine to all patients prior to transplantation. In addition, black patients, and especially those with a history of HPV, should be taught how to identify potential cancerous lesions in their groin areas.

“The ultimate takeaway is that though people of colour are at decreased risk for skin cancer, they’re not not at risk. And those people have different risk factors,” Dr. Chung said. “So when you see a person of colour who is a transplant patient, you need to approach them differently, depending on their skin type and tone, where they are from and their medical history.”

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