Relationship Between BCC and Transplant Patients Analyzed at EADV Congress

Clio Dessinioti, MD, dermatologist and clinical fellow, department of dermatology, Andreas Syggros Hospital, University of Athens, Greece discussed the relationship between transplant patients and the occurrence of basal cell carcinoma at the EADV Congress 2022 in Milan, Italy.

Transplant patients are more prone to a basal cell carcinoma (BCC) diagnosis because they require long-term use of immunosuppressant medications to prevent organ rejection. Those medications can impair the capacity of the immune system to repair or destroy UV rays, which are a major factor in the development of skin.¹

Dessinioti revealed a clinicopathologic study of 176 cases of transplant patients with BCC. Most of the patients developed BCC 6.9 years after transplantation; sooner after heart transplants than kidney transplants. Most superficial cases were successfully removed with cryotherapy after biopsy; others were treated with surgical removal of the cancerous skin. Mortality rates are low in patients with skin cancer, but BCC can grow and aggressively cause extensive tissue destruction. Its frequency of metastatic dissemination is very low (<.1%) but cases of metastases to lymph nodes, lung, bone, and liver. The average lifetime risk for white-skinned individuals to develop BCC is approximately 30%.

BCC is characterized by pale red or pearly smooth lumps, often on the head and neck or pink, scaly patches on the truck and limbs. ² According to Dessinioti, the incidence rates of BCC are increasing each year. These trends may be due to increases in both acute and prolonged sun exposure (due to altered lifestyle and pro-tanning behavior), and the depletion of stratospheric ozone, together with the increasing aging of the general population Dessinioti said the epidemiologic association of UV exposure with the development of BCC is clear; however, there is still much to be learned about its molecular pathogenesis and the role of UV radiation.

References:

1.C. Dessinioti. Management of BCC in immune-suppressed patients. Presented at European Academy of Dermatology and Venerology 31st Annual Congress. August 7-10, 2022; Milan, Italy.

2.Dessinioti C, Antoniou C, Katsambas A, Stratigos AJ. Basal cell carcinoma: what’s new under the sun. Photochemistry and Photobiology. 2010;86(3):481-491.