de Graaf Y G L, de Fijter J W, Posma A N, Feltkamp M C W, Claas F H J, Bouwes Bavinck J N
Afd. Dermatologie, Leids Universitair Medisch Centrum, Postbus 9600, 2300 RC Leiden.
Ned Tijdschr Geneeskd. 2005 Mar 5;149(10):511-7.
Solid organ transplant patients have an increased risk of cutaneous squamous cell carcinomas compared to the immunocompetent population, and often develop multiple and sometimes aggressive tumours. There are few published studies or reviews, which provide guidance to the clinician in the management of these patients. In the prevention of skin cancer in organ transplant patients, patient education about the harmful effects of ultraviolet radiation, sun protection, and the early recognition of (pre)malignant skin lesions should be emphasised. Furthermore, close follow-up by a dermatologist and treatment of (pre)malignant lesions in an early stage are necessary. Chemoprevention of skin cancer can be achieved through systemic retinoids. Reduction of the dose of immunosuppressive agents can be considered. Excision is the first treatment of choice for squamous cell and basal cell carcinomas. In selected rumours curettage and electrodessication can be performed.
与免疫功能正常人群相比,实体器官移植患者患皮肤鳞状细胞癌的风险增加,且常发生多发性肿瘤,有时还会出现侵袭性肿瘤。目前发表的研究和综述较少,无法为临床医生管理这些患者提供指导。在预防器官移植患者皮肤癌方面,应强调对患者进行紫外线辐射危害、防晒以及早期识别(癌)前皮肤病变的教育。此外,皮肤科医生的密切随访以及早期治疗(癌)前病变是必要的。皮肤癌的化学预防可通过全身使用维甲酸来实现。可以考虑减少免疫抑制剂的剂量。手术切除是鳞状细胞癌和基底细胞癌的首选治疗方法。对于某些肿瘤,可进行刮除术和电干燥术。