Department of Dermatology and Division of Transplantation, Department of Surgery, Emory University, Atlanta, Georgia.
Department of Dermatology and Oncology, University of Rochester, Rochester, New York.
J Am Acad Dermatol. 2011 Aug;65(2):263-279. doi: 10.1016/j.jaad.2010.11.063.
The management of skin cancer in solid organ transplant recipients is a challenge to both the dermatologist and transplant physician. Part II of this continuing medical education review offers an approach to the management of this increasing problem. The importance of specialty dermatology clinics providing access to transplant patients, frequent skin cancer screening, patient education, and multidisciplinary care is discussed. The management of low risk squamous cell carcinoma with topical therapies, photodynamic therapy, systemic retinoids, and capecitabine is reviewed. Revision of immunosuppression in the management of high-risk patients is discussed in association with the potential role of sentinel lymph node biopsy for aggressive disease. Finally, management of in-transit and metastatic squamous cell carcinoma is reviewed, with a discussion of the role of more recent innovative therapies, including epidermal growth factor receptor inhibitors in advanced squamous cell carcinoma in solid organ transplant recipients.
实体器官移植受者皮肤癌的管理对皮肤科医生和移植医生都是一个挑战。本继续教育综述的第二部分提供了一种处理这个日益增多的问题的方法。讨论了提供给移植患者的专业皮肤科诊所、频繁的皮肤癌筛查、患者教育和多学科护理的重要性。审查了用局部治疗、光动力疗法、全身维甲酸和卡培他滨治疗低危鳞状细胞癌的方法。讨论了与高危患者中免疫抑制的修订相关的哨兵淋巴结活检在侵袭性疾病中的潜在作用。最后,审查了转移性和转移性鳞状细胞癌的治疗方法,并讨论了包括表皮生长因子受体抑制剂在内的治疗实体器官移植受者晚期鳞状细胞癌的最新创新疗法的作用。