Cutaneous Squamous Cell Carcinomas in OrganTransplant Recipients

Journal of Clinical Medicine

Christopher Downing¹  Stephen K. Tyring¹  Ramya Chockalingam² 

[1] Center for Clinical Studies, 1401 Binz, Suite 200, Houston, TX 77004, USA;Medical School, the University of Texas Health Science Center at Houston, 6431 Fannin,Houston, TX 77030, USA;

关键词: human papillomavirus (HPV);    organ transplant;    skin cancer;    squamouscell carcinoma;   

DOI  :  10.3390/jcm4061229

来源: DOAJ

【 摘 要 】

Non-melanoma skin cancers represent a major cause of morbidity afterorgan 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 ofpost-transplant SCCs. The underlying mechanism of carcinogenesis has been attributedto the E6 and E7 proteins of HPV. Specific immunosuppressive medications, such asthe calcineurin inhibitors and azathioprine, are associated with a higher incidence ofpost-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.

【 授权许可】

Unknown