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Cutaneous Squamous Cell Carcinomas in Organ Transplant Recipients

Non-melanoma skin cancers represent a major cause of morbidity after organ transplantation. Squamous cell carcinomas (SCC) are the most common cutaneous malignancies seen in this population, with a 65–100 fold greater incidence in organ transplant recipients compared to the general population. In re...

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Autores principales: Chockalingam, Ramya, Downing, Christopher, Tyring, Stephen K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4484997/
https://www.ncbi.nlm.nih.gov/pubmed/26239556
http://dx.doi.org/10.3390/jcm4061229
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author Chockalingam, Ramya
Downing, Christopher
Tyring, Stephen K.
author_facet Chockalingam, Ramya
Downing, Christopher
Tyring, Stephen K.
author_sort Chockalingam, Ramya
collection PubMed
description Non-melanoma skin cancers represent a major cause of morbidity after organ transplantation. Squamous cell carcinomas (SCC) are the most common cutaneous malignancies seen in this population, with a 65–100 fold greater incidence in organ transplant recipients compared to the general population. In recent years, human papillomaviruses (HPV) of the beta genus have been implicated in the pathogenesis of post-transplant SCCs. The underlying mechanism of carcinogenesis has been attributed to the E6 and E7 proteins of HPV. Specific immunosuppressive medications, such as the calcineurin inhibitors and azathioprine, are associated with a higher incidence of post-transplant SCCs compared to other immunosuppressive agents. Compared to other immunosuppressives, mTOR inhibitors and mycophenolate mofetil have been associated with a decreased risk of developing post-transplant non-melanoma skin cancers. As a result, they may represent ideal immunosuppressive medications in organ transplant recipients. Treatment options for post-transplant SCCs include surgical excision, Mohs micrographic surgery, systemic retinoid therapy, adjunct topical therapy, electrodessication and curettage, and radiation therapy. This review will discuss the epidemiology, risk factors, and management options of post-transplant SCCs. In addition, the underlying mechanisms of beta-HPV mediated carcinogenesis will be discussed.
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spelling pubmed-44849972015-07-28 Cutaneous Squamous Cell Carcinomas in Organ Transplant Recipients Chockalingam, Ramya Downing, Christopher Tyring, Stephen K. J Clin Med Review Non-melanoma skin cancers represent a major cause of morbidity after organ transplantation. Squamous cell carcinomas (SCC) are the most common cutaneous malignancies seen in this population, with a 65–100 fold greater incidence in organ transplant recipients compared to the general population. In recent years, human papillomaviruses (HPV) of the beta genus have been implicated in the pathogenesis of post-transplant SCCs. The underlying mechanism of carcinogenesis has been attributed to the E6 and E7 proteins of HPV. Specific immunosuppressive medications, such as the calcineurin inhibitors and azathioprine, are associated with a higher incidence of post-transplant SCCs compared to other immunosuppressive agents. Compared to other immunosuppressives, mTOR inhibitors and mycophenolate mofetil have been associated with a decreased risk of developing post-transplant non-melanoma skin cancers. As a result, they may represent ideal immunosuppressive medications in organ transplant recipients. Treatment options for post-transplant SCCs include surgical excision, Mohs micrographic surgery, systemic retinoid therapy, adjunct topical therapy, electrodessication and curettage, and radiation therapy. This review will discuss the epidemiology, risk factors, and management options of post-transplant SCCs. In addition, the underlying mechanisms of beta-HPV mediated carcinogenesis will be discussed. MDPI 2015-06-03 /pmc/articles/PMC4484997/ /pubmed/26239556 http://dx.doi.org/10.3390/jcm4061229 Text en © 2015 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Chockalingam, Ramya
Downing, Christopher
Tyring, Stephen K.
Cutaneous Squamous Cell Carcinomas in Organ Transplant Recipients
title Cutaneous Squamous Cell Carcinomas in Organ Transplant Recipients
title_full Cutaneous Squamous Cell Carcinomas in Organ Transplant Recipients
title_fullStr Cutaneous Squamous Cell Carcinomas in Organ Transplant Recipients
title_full_unstemmed Cutaneous Squamous Cell Carcinomas in Organ Transplant Recipients
title_short Cutaneous Squamous Cell Carcinomas in Organ Transplant Recipients
title_sort cutaneous squamous cell carcinomas in organ transplant recipients
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4484997/
https://www.ncbi.nlm.nih.gov/pubmed/26239556
http://dx.doi.org/10.3390/jcm4061229
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