Aggressive undifferentiated squamous cell carcinoma in an immunosuppressed patient after kidney transplantation

A 56-year-old man developed a highly aggressive squamous cell carcinoma (SCC) on the upper back five years ago renal transplantation and subsequent immunosuppression. The tumor was excised using the three-dimensional micrographic technique; after the formation of granulation tissue, the wound was covered with a Meshgraft. His cyclosporine A dose was reduced from 2.5 to 2.0 mg/kg. The patient was counseled on sun avoidance and use of sunscreens, as well as placed on low-dose oral acitretin and imiquimod 5% cream to control actinic keratoses. He is followed every 3 months by a dermatologist and has shown no evidence of recurrence over 2 years.