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Related Experiment Videos

C Paugam1, B Dréno1

  • 1Clinique dermatologique, Hôtel-Dieu CHU de Nantes, 1 place Alexis-Ricordeau, 44035 Nantes Cedex 01, France.

Annales De Dermatologie Et De Venereologie
|May 29, 2019
PubMed
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Organ transplant recipients (OTRs) face a high risk of actinic keratosis (AK) and skin cancer. Early management strategies, including photodynamic therapy and immunosuppressive drug adjustments, are crucial for OTRs.

Area of Science:

  • Dermatology
  • Transplantation Medicine
  • Oncology

Background:

  • Organ transplant recipients (OTRs) have a significantly higher risk of developing actinic keratosis (AK) and skin cancer compared to the general population.
  • Current management strategies for AK are primarily studied in immunocompetent individuals, with limited data available for OTRs.
  • Effective AK management in OTRs is critical due to their increased susceptibility and potential for serious skin complications.

Purpose of the Study:

  • To review and synthesize current knowledge on actinic keratosis (AK) management in organ transplant recipients (OTRs).
  • To evaluate the efficacy of various therapeutic options, including photodynamic therapy (PDT), topical agents, and systemic treatments for AK in OTRs.
  • To discuss the role of immunosuppressive drug management in preventing AK and skin cancer development in OTRs.
Keywords:
Actinic keratosisGreffésKératoses actiniquesOrgan transplant recipientsTransplantés

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Main Methods:

  • Review of existing literature on AK management in organ transplant recipients (OTRs).
  • Analysis of studies investigating topical and systemic treatments such as photodynamic therapy (PDT), imiquimod, topical NSAIDs, 5-fluorouracil, nicotinamide, and oral retinoids.
  • Examination of the impact of immunosuppressive drug regimens, including mTOR inhibitors, azathioprine, ciclosporin, and tacrolimus, on AK development.

Main Results:

  • Photodynamic therapy (PDT) appears promising for AK treatment in OTRs, though robust evidence is limited.
  • Topical agents like imiquimod, NSAIDs, and 5-fluorouracil have been used in small studies with varying outcomes.
  • Nicotinamide and oral retinoids show potential as preventive measures.
  • Specific immunosuppressive drugs (azathioprine, ciclosporin, tacrolimus) are associated with increased risk, while mTOR inhibitors may be protective.

Conclusions:

  • Actinic keratosis (AK) management in organ transplant recipients (OTRs) requires tailored approaches due to their unique risk profile.
  • Photodynamic therapy (PDT) warrants further investigation as a primary treatment modality for AK in OTRs.
  • Optimizing immunosuppressive drug regimens, potentially by switching to mTOR inhibitors, is a key strategy for reducing skin cancer risk in OTRs.