Cutaneous cancers after organ transplantation

peer reviewedDrug-induced immunosuppression is the necessary corollary of organ transplantation. This situation is responsible for an increased risk of both infection and neoplasia. Cutaneous carcinomas are the most frequent malignancies developing after organ transplantation. The usual squamous to basal cell carcinoma ratio is increased and reversed compared to the general population. Carcinomas primarily result from the combination of cumulative sun exposure, fair skin phototype and effects of immunosuppressive drugs. These treatments impair the systemic immunosurveillance and may exert a direct carcinogenic effect. The severity of these carcinomas is due to their multiplicity and to the occurrence of more aggressive lesions. Prevention relies on a strict adherence to sun protection after transplantation, and on refined immunosuppressive strategies. The treatment of the neoplastic lesions is based on their early and complete excision with histological control of the nature of the neoplasm, the safety surgical margins, and the determination of prognostic factors