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Optimal Management of Skin Cancer in Immunosuppressed Patients

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Abstract

Skin cancer is the most common malignancy in humans with basal cell carcinoma representing the majority of cases in the general population. The prevalence of skin cancer is increased amongst immunosuppressed patients such as those with lymphoproliferative disorders including non-Hodgkin lymphoma and chronic lymphocytic leukemia or those with iatrogenic immunosuppression following organ transplantation. In addition, these patients experience greater morbidity and mortality associated with skin cancers. The most common skin cancer in immunosuppressed patients is squamous cell carcinoma, which often presents with more aggressive features and has a greater rate of metastasis. This article reviews the risk factors, etiology, clinical presentation, and prevalence of skin cancer amongst immunosuppressed patients, including organ transplant, lymphoproliferative disorders, autoimmune disorders, and human immunodeficiency virus. We also provide a comprehensive review of treatment guidelines for immunosuppressed patients with cutaneous malignancy. Surgical therapy is the cornerstone of treatment; however, we also discuss pharmacologic treatment options, lifestyle modifications, and revision of immunosuppressive regimens.

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Conflict of interest

LR Brin, AS Zubair, and Dr. JD Brewer have no conflicts of interest to declare. No sources of funding were used in the preparation of this paper.

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Authors and Affiliations

  1. Creighton University School of Medicine, Omaha, NE, USA

    Lauren Brin

  2. Mayo Medical School, Mayo Clinic, Rochester, MN, USA

    Adeel S. Zubair

  3. Division of Dermatologic Surgery, Department of Dermatology, Mayo Clinic/Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA

    Jerry D. Brewer

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  1. Lauren Brin
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  2. Adeel S. Zubair
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  3. Jerry D. Brewer
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Correspondence to Jerry D. Brewer.

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Brin, L., Zubair, A.S. & Brewer, J.D. Optimal Management of Skin Cancer in Immunosuppressed Patients. Am J Clin Dermatol 15, 339–356 (2014). https://doi.org/10.1007/s40257-014-0085-5

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