Nephrol Dial Transplant (2002) 17: 31-32
© 2002 European Renal Association-European Dialysis and Transplant Association
IV.6.2 Skin cancers: prevention and treatment
GuidelinesD. Due to the high prevalence of skin cancers after organ transplantation, it is highly recommended to inform patients about self-awareness.
(Evidence level C)
E. Primary prevention should include the avoidance of sun exposure, use of protective clothing and use of an effective sunscreen (protection factor >15) for unclothed body parts (head, neck, hands and arms) in order to prevent the occurrence of squamous-cell carcinoma. This is the most frequent skin tumour in transplant recipients, and its preferential location is the head.
(Evidence level A)
F. Recipients with pre-malignant skin lesions (warts, epidermodysplasia verruciformis or actinic keratoses) should be referred early to a dermatologist for active treatment and close follow-up.
(Evidence level B)
G. All skin cancers should be completely removed by a dermatologist with appropriate techniques, such as electro-desiccation with curettage, cryotherapy or surgical excision.
(Evidence level B)
H. Secondary prevention for recipients should include close follow-up by a dermatologist (at least every 6 months), the use of topical retinoids to control actinic keratoses and to diminish squamous-cell carcinoma recurrence, and reduction of immunosuppression whenever possible.
(Evidence level C)
I. In recipients with multiple and/or recurrent skin cancers, the use of systemic retinoids, such as low-dose acitretin, could be recommended for months/years, if well tolerated, in addition to further reduction in immunosuppression whenever possible.
(Evidence level C)