Conference Coverage

Posttransplant skin conditions vary widely by ethnicity

 

Key clinical point: Skin disorders after organ transplant differ widely by ethnicity.

Major finding: Posttransplant basal cell and squamous cell carcinomas are most common in white Northern Europeans (at nearly 25%), while Kaposi’s sarcoma was higher than expected (nearly 10%) in black African/Caribbean patients.

Study details: Analysis of 1,125 patients from a single transplant center who received organ transplants and developed skin problems over a median follow-up time of 5 to more than 12 years, depending on ethnicity.

Disclosures: No study funding was reported. The authors had no disclosures.

Source: Kentley J et al. AAD 2018, Session F055.


 

REPORTING FROM AAD 18

– A new study finds that the risk of skin cancers in organ transplant recipients may vary widely by ethnicity.

“The most important findings from our study are the high rates of keratinocyte neoplasms observed in our white Northern European patients, but also in those of Far East Asian descent. Dermatologists should also appreciate the high risk of Kaposi’s sarcoma (KS) in patients originating from Sub-Saharan Africa,” Jonathan Kentley, MBBS, of Royal London Hospital, said in an interview. He presented the study findings at the annual meeting of the American Academy of Dermatology.

Dr. Jonathan Kentley of Royal London Hospital

Dr. Jonathan Kentley

“As the immune system plays a pivotal role in the surveillance and destruction of skin cancer, iatrogenic immunosuppression has a profound impact on morbidity and mortality in these patients,” he noted. “This presents a significant health issue for transplant recipients, and they are at an increased risk of almost every skin cancer. Squamous cell carcinoma (SCC), in particular, has been intensively studied, and some literature suggests that transplant recipients are at a more than 100-times increased risk of SCC.”

For the study, Dr. Kentley and colleagues sought to better understand ethnic differences in skin disorders in patients who have received organ transplants, since many previous studies have included few nonwhite subjects.

They analyzed an organ transplant center database for the years 1989-2016, and tracked 1,304 consecutive patients – which included 1,125 with skin problems. The overall population was 64% male with a median age in the early 40s, and almost all (1,276) had undergone renal transplants. A relative handful underwent liver, lung, heart, and pancreas transplants.

The majority of patients (885) were white Northern Europeans, but there were also significant numbers of people with South Asian (202), black African/Caribbean (131) and white/Mediterranean (52) heritage. A small number were Far East Asian (26) and Middle Eastern (8). The median follow-up time for the ethnic groups varied from about 5 years to about 12 years.

The researchers found that basal cell carcinoma was most common in white Northern European patients, at nearly 25%, with other groups under 10%. SCC was common in white Northern European patients and Far East Asians, both at nearly 25%.

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