Awareness of skin cancer by kidney transplant patients☆,☆☆

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Abstract

Background: Skin cancer is the most common malignancy occurring after kidney transplantation. Objective: Our purpose was to identify the skin problems of kidney transplant recipients, the extent of their awareness of skin cancer, and interest in skin cancer screenings. Methods: One hundred twenty-two patients were administered an oral questionnaire during regular follow-up at a renal transplant clinic. Results: The average time from transplantation was 3.1 years. Thirty-nine percent of patients reported skin problems, including warts, fungal infection, and skin cancer. Forty-one percent of patients were unable to recall specific skin cancer education, and 52% expressed an interest in skin cancer screening. Twenty-seven percent of patients had seen a dermatologist since their transplant, but only 14% were followed up regularly by a dermatologist. Conclusion: We believe the need for continuing skin cancer education and early detection and treatment of skin lesions establishes an important role for the dermatologist on the transplant recipient’s health care team.(J Am Acad Dermatol 1999;40:697-701.)

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METHODS

A total of 122 patients were administered an oral questionnaire during a regularly scheduled follow-up visit to a renal transplant clinic. Patients were asked (1) general data: age, race; (2) transplant information: date of kidney transplant, reason for kidney failure, current and past immunosuppressant medications; (3) skin cancer education: “do you recall anyone discussing the potential side effects on your skin of the medications which you take to prevent transplant rejection?”, “do you

RESULTS

The average age of patients in our study was 50 years (range, 25-80 years). Sixty percent (n = 73) of patients were men. One hundred ten patients were Caucasian, 7 were African American, 3 Hispanic, 1 Asian, and 1 person was of Middle Eastern descent. Average time from transplantation was 3.1 years (range, 1 week-27 years).

Many patients were taking a combination of immunosuppressants, most commonly cyclosporine and prednisone, but several had taken azathioprine in the past, and several others

DISCUSSION

Kidney transplantation is a stressful time in the life of the recipient and his/her family. In addition to the physical stresses of renal failure, surgery, and immunosuppression, the emotional stress can be equally as difficult. It is at this time that kidney transplant recipients are inundated with information about immunosuppressant medications and the life-threatening side effects that may occur after long-term use of these drugs. Effectively learning about the risk of skin cancer as well as

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Reprint requests: Elizabeth M. Billingsley, MD, Department of Medicine/Section of Dermatology, The Pennsylvania State University College of Medicine, PO Box 850, Hershey, PA 17033.

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Copyright © 1999 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.