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Background and Objectives: Solid organ transplant recipients (SOTRs) are at increased risk of skin cancer and suffer from greater disease-specific morbidity and mortality. To risk stratify the expanding SOTR population for more targeted skin cancer screening, a detailed understanding of risk factors is needed. Using combined clinical and pathological data to capture prevalence of actinic keratosis (AK) and skin cancer, this study aimed to identify risk factors of skin cancer development in a Danish SOTR cohort. Methods: The trial comprised a retrospective cohort study of patients attending organ transplant clinics at the dermatological departments of Bispebjerg and Gentofte Hospitals in Copenhagen, Denmark, between 2009 and 2021. In addition to pathology records, AK prevalence was determined by review of electronic medical records (EMRs) of SOTR visits which specifically included descriptions of clinical AK. Prevalence of skin cancer, here defined as basal cell carcinoma (BCC), squamous cell carcinoma (SCC) (invasive or in situ), or melanoma (invasive or in situ), was determined by EMR and pathology code review. Additional data extracted from EMRs included age, sex, Fitzpatrick skin type, transplantation date and type, and immunosuppressive therapy. The effect of risk factors on skin cancer was calculated by Cox proportional hazards regression. Results: A total of 822 SOTRs were included with a mean follow-up duration of 10.8 years (SD 2.4 years). A skin dysplasia diagnosis was identified in 30% (n = 250) of the population, consisting of either AK (22%; n = 177), skin cancer (23%; n = 186) or both (14%; n = 113). An AK diagnosis predicted both SCC (odds ratio [OR]: 31.5 [95% CI: 9.8–100.6], p < 0.0001) and BCC development (OR: 2.3 [95% CI: 1.6–3.3], p < 0.0001), with AKs diagnosed an average 3.1 years before the first SCC (p < 0.0001). Correspondingly, while the risk of SCC in SOTRs without AK was 1.4% 25 years after transplantation, SOTRs with AKs had a 23, Background and Objectives: Solid organ transplant recipients (SOTRs) are at increased risk of skin cancer and suffer from greater disease-specific morbidity and mortality. To risk stratify the expanding SOTR population for more targeted skin cancer screening, a detailed understanding of risk factors is needed. Using combined clinical and pathological data to capture prevalence of actinic keratosis (AK) and skin cancer, this study aimed to identify risk factors of skin cancer development in a Danish SOTR cohort. Methods: The trial comprised a retrospective cohort study of patients attending organ transplant clinics at the dermatological departments of Bispebjerg and Gentofte Hospitals in Copenhagen, Denmark, between 2009 and 2021. In addition to pathology records, AK prevalence was determined by review of electronic medical records (EMRs) of SOTR visits which specifically included descriptions of clinical AK. Prevalence of skin cancer, here defined as basal cell carcinoma (BCC), squamous cell carcinoma (SCC) (invasive or in situ), or melanoma (invasive or in situ), was determined by EMR and pathology code review. Additional data extracted from EMRs included age, sex, Fitzpatrick skin type, transplantation date and type, and immunosuppressive therapy. The effect of risk factors on skin cancer was calculated by Cox proportional hazards regression. Results: A total of 822 SOTRs were included with a mean follow-up duration of 10.8 years (SD 2.4 years). A skin dysplasia diagnosis was identified in 30% (n = 250) of the population, consisting of either AK (22%; n = 177), skin cancer (23%; n = 186) or both (14%; n = 113). An AK diagnosis predicted both SCC (odds ratio [OR]: 31.5 [95% CI: 9.8-100.6], p < 0.0001) and BCC development (OR: 2.3 [95% CI: 1.6-3.3], p < 0.0001), with AKs diagnosed an average 3.1 years before the first SCC (p < 0.0001). Correspondingly, while the risk of SCC in SOTRs without AK was 1.4% 25 years after transplantation, SOTRs with AKs had a

Background and Objectives: Solid organ transplant recipients (SOTRs) are at increased risk of skin cancer and suffer from greater disease-specific morbidity and mortality. To risk stratify the expanding SOTR population for more targeted skin cancer screening, a detailed understanding of risk factors is needed. Using combined clinical and pathological data to capture prevalence of actinic keratosis (AK) and skin cancer, this study aimed to identify risk factors of skin cancer development in a Danish SOTR cohort. Methods: The trial comprised a retrospective cohort study of patients attending organ transplant clinics at the dermatological departments of Bispebjerg and Gentofte Hospitals in Copenhagen, Denmark, between 2009 and 2021. In addition to pathology records, AK prevalence was determined by review of electronic medical records (EMRs) of SOTR visits which specifically included descriptions of clinical AK. Prevalence of skin cancer, here defined as basal cell carcinoma (BCC), squamous cell carcinoma (SCC) (invasive or in situ), or melanoma (invasive or in situ), was determined by EMR and pathology code review. Additional data extracted from EMRs included age, sex, Fitzpatrick skin type, transplantation date and type, and immunosuppressive therapy. The effect of risk factors on skin cancer was calculated by Cox proportional hazards regression. Results: A total of 822 SOTRs were included with a mean follow-up duration of 10.8 years (SD 2.4 years). A skin dysplasia diagnosis was identified in 30% (n = 250) of the population, consisting of either AK (22%; n = 177), skin cancer (23%; n = 186) or both (14%; n = 113). An AK diagnosis predicted both SCC (odds ratio [OR]: 31.5 [95% CI: 9.8–100.6], p < 0.0001) and BCC development (OR: 2.3 [95% CI: 1.6–3.3], p < 0.0001), with AKs diagnosed an average 3.1 years before the first SCC (p < 0.0001). Correspondingly, while the risk of SCC in SOTRs without AK was 1.4% 25 years after transplantation, SOTRs with AKs had a 23, Background and Objectives: Solid organ transplant recipients (SOTRs) are at increased risk of skin cancer and suffer from greater disease-specific morbidity and mortality. To risk stratify the expanding SOTR population for more targeted skin cancer screening, a detailed understanding of risk factors is needed. Using combined clinical and pathological data to capture prevalence of actinic keratosis (AK) and skin cancer, this study aimed to identify risk factors of skin cancer development in a Danish SOTR cohort. Methods: The trial comprised a retrospective cohort study of patients attending organ transplant clinics at the dermatological departments of Bispebjerg and Gentofte Hospitals in Copenhagen, Denmark, between 2009 and 2021. In addition to pathology records, AK prevalence was determined by review of electronic medical records (EMRs) of SOTR visits which specifically included descriptions of clinical AK. Prevalence of skin cancer, here defined as basal cell carcinoma (BCC), squamous cell carcinoma (SCC) (invasive or in situ), or melanoma (invasive or in situ), was determined by EMR and pathology code review. Additional data extracted from EMRs included age, sex, Fitzpatrick skin type, transplantation date and type, and immunosuppressive therapy. The effect of risk factors on skin cancer was calculated by Cox proportional hazards regression. Results: A total of 822 SOTRs were included with a mean follow-up duration of 10.8 years (SD 2.4 years). A skin dysplasia diagnosis was identified in 30% (n = 250) of the population, consisting of either AK (22%; n = 177), skin cancer (23%; n = 186) or both (14%; n = 113). An AK diagnosis predicted both SCC (odds ratio [OR]: 31.5 [95% CI: 9.8-100.6], p < 0.0001) and BCC development (OR: 2.3 [95% CI: 1.6-3.3], p < 0.0001), with AKs diagnosed an average 3.1 years before the first SCC (p < 0.0001). Correspondingly, while the risk of SCC in SOTRs without AK was 1.4% 25 years after transplantation, SOTRs with AKs had a

Two round tables involving experts were organized in order to reach a consensus on the management of patients with actinic keratosis (AK). In the first, seven clinical questions were selected and analyzed by a systematic literature review, using a Population, Intervention, Control, and Outcomes framework; in the second, the experts discussed relevant evidences and a consensus statement for each question was developed. Consensus was reached among experts on how to best treat AK patients with respect to different clinical scenarios and special populations. Lesion-directed treatments are preferred in patients with few AKs. Patients with multiple AKs are challenging, with more than one treatment usually needed to achieve complete lesion clearance or a high lesion response rate, therapy should be personalized, based on previous treatments, patient, and lesion characteristics. Methyl aminolevulinate-PDT, DL (day light) PDT, and imiquimod cream were demonstrated to have the lowest percentage of new AKs after post treatment follow-up. For IMQ 5% and 3.75%, a higher intensity of skin reactions is associated with higher efficacy. Photodynamic therapy (PDT) is the most studied treatment for AKs on the arms. Regular sunscreen use helps preventing new AKs. Oral nicotinamide 500 mg twice daily, systemic retinoids and regular sunscreen use were demonstrated to reduce the number of new squamous cell carcinomas in patients with AKs. Limited evidence is available for the treatment of AKs in organ transplant recipients. There is no evidence in favor or against the use of any of the available treatments in patients suffering from hematological cancer.

Several studies have shown a two- to five-fold increased risk of melanoma in organ transplant recipients (OTRs) due to chronic immunosuppression [1]. The reported standardized incidence ratio of melanoma in OTRs ranges from slightly above 1 [2] to 8.0 [3]. It is difficult to draw conclusions on the true relative risk of melanoma in OTRs because some studies reported only case series [4], while others analysed large data sets that were not designed for this purpose [5]. Here, we report the estimated [...]

Non-melanoma skin cancers induced by solar radiation are the most frequent types of cancers in humans and their incidence is increasing worldwide. Ultraviolet radiation (UV) is a major environmental cause. The individual risk of skin cancer is due both to the total cumulative exposure to UV radiation and to sporadic patterns of sun exposure as during free time. Organ transplant recipients have a relative risk of developing squamous cell carcinoma 100-fold higher than healthy subjects, whereas the risk of developing basal cell carcinoma is increased by 10. Beside the direct effect on keratinocyte DNA, UV radiations have also a negative effect on the local immunosurveillance in the exposed areas and on systemic immunity. Educational programs on sun exposure for organ transplant recipients recommend to limit the time of exposure and to apply sunscreen creams. Sunscreen creams are topical preparations that attenuate the effects of UV radiation on the skin. Recently the safety of sunscreen creams is a matter of discussion because of the toxicological studies performed on chemical filters. The majority of chemical filters absorb through the skin, then into the blood. T-shirts, hats and sunglasses provide full protection from UV rays. Body areas (face, neck, ears and décolleté) exposed to solar radiation can be efficiently protected applying a blend of mineral powders (clays, bentonite, kaolin, montmorillonite) formulated to reflect sunrays. The use of mineral powders as sunscreens is encouraged also for dialysed subjects and for patients with autoimmune diseases., non disponibile

Non-melanoma skin cancers induced by solar radiation are the most frequent types of cancers in humans and their incidence is increasing worldwide. Ultraviolet radiation (UV) is a major environmental cause. The individual risk of skin cancer is due both to the total cumulative exposure to UV radiation and to sporadic patterns of sun exposure as during free time. Organ transplant recipients have a relative risk of developing squamous cell carcinoma 100-fold higher than healthy subjects, whereas the risk of developing basal cell carcinoma is increased by 10. Beside the direct effect on keratinocyte DNA, UV radiations have also a negative effect on the local immunosurveillance in the exposed areas and on systemic immunity. Educational programs on sun exposure for organ transplant recipients recommend to limit the time of exposure and to apply sunscreen creams. Sunscreen creams are topical preparations that attenuate the effects of UV radiation on the skin. Recently the safety of sunscreen creams is a matter of discussion because of the toxicological studies performed on chemical filters. The majority of chemical filters absorb through the skin, then into the blood. T-shirts, hats and sunglasses provide full protection from UV rays. Body areas (face, neck, ears and décolleté) exposed to solar radiation can be efficiently protected applying a blend of mineral powders (clays, bentonite, kaolin, montmorillonite) formulated to reflect sunrays. The use of mineral powders as sunscreens is encouraged also for dialysed subjects and for patients with autoimmune diseases., non disponibile

Topical photodynamic therapy is an effective and safe noninvasive treatment for low-risk basal cell carcinoma, with the advantage of an excellent cosmetic outcome. Efficacy of photodynamic therapy in basal cell carcinoma is supported by substantial research and clinical trials. In this article, we review the procedure, indications and clinical evidences for the use of photodynamic therapy in the treatment of basal cell carcinoma.

Non-melanoma skin cancers induced by solar radiation are the most frequent types of cancers in humans and their incidence is increasing worldwide. Ultraviolet radiation (UV) is a major environmental cause. The individual risk of skin cancer is due both to the total cumulative exposure to UV radiation and to sporadic patterns of sun exposure as during free time. Organ transplant recipients have a relative risk of developing squamous cell carcinoma 100-fold higher than healthy subjects, whereas the risk of developing basal cell carcinoma is increased by 10. Beside the direct effect on keratinocyte DNA, UV radiations have also a negative effect on the local immunosurveillance in the exposed areas and on systemic immunity. Educational programs on sun exposure for organ transplant recipients recommend to limit the time of exposure and to apply sunscreen creams. Sunscreen creams are topical preparations that attenuate the effects of UV radiation on the skin. Recently the safety of sunscreen creams is a matter of discussion because of the toxicological studies performed on chemical filters. The majority of chemical filters absorb through the skin, then into the blood. T-shirts, hats and sunglasses provide full protection from UV rays. Body areas (face, neck, ears and décolleté) exposed to solar radiation can be efficiently protected applying a blend of mineral powders (clays, bentonite, kaolin, montmorillonite) formulated to reflect sunrays. The use of mineral powders as sunscreens is encouraged also for dialysed subjects and for patients with autoimmune diseases., non disponibile

SCOPUS: ar.j, FLWIN, info:eu-repo/semantics/published

SCOPUS: ar.j, FLWIN, info:eu-repo/semantics/published