Cutaneous Malignancies in Solid Organ Transplant Recipients

In solid organ transplant recipients (SOTRs), long-term utilization of immunosuppressive therapy is a critical component of preventing graft rejection. Immunosuppression medications, however, inadvertently lead to decreased tumor surveillance; consequently, SOTRs represent a high-risk population for the development of malignant tumors. In particular, SOTRs are prone to developing skin cancers, which exhibit unique epidemiologic, pathophysiologic, and prognostic characteristics in this patient subset. In this chapter, we discuss the most commonly reported skin cancers in SOTRs: keratinocyte carcinomas (i.e., squamous cell carcinoma and basal cell carcinoma), Kaposi’s sarcoma, Merkel cell carcinoma, malignant melanoma, primary cutaneous posttransplantation lymphoproliferative disease (PTLD), cutaneous sarcomas, and appendageal carcinomas. Because these tumors are aggressive and tend to respond poorly to standard surgery, radiation therapy, and chemotherapy, SOTRs require patient education and motivational support, regular follow-up, and management by an interdisciplinary clinician team. Further research and clinical trials are warranted to improve treatment protocols.