Skin cancer in immunosuppressed patients

Organ transplant recipients suffer from an increased incidence and recurrence rate of nonmelanoma skin cancers. These cancers are often more aggressive than those in the general population, resulting in significant morbidity and mortality. Often times, routine treatment modalities are not adequate and the use of different management strategies is necessary. Treatment modalities, including surgical excision, Mohs micrographic surgery, physically destructive modalities, topical therapy, and photodynamic therapy may be used. Combinations of these therapies may be used in rotation for treatment of extensive field disease. Chemoprophylaxis with oral retinoids and alteration of the immune suppression regimen may be indicated for specific cases. In addition, newly emerging therapies for squamous cell carcinomas including cetuximab and capecitabine may offer heightened control in organ transplant patients with significant cutaneous disease.