Tsironi Theodora, Gaitanis Georgios, Pappas Charalambos, Koutlas Vasileios, Dounousi Evangelia, Bassukas Ioannis D
Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, University Campus, Ioannina, Greece.
Department of Nephrology, University Hospital of Ioannina, Ioannina, Greece.
Dermatol Ther. 2022 May;35(5):e15405. doi: 10.1111/dth.15405. Epub 2022 Mar 20.
Keratinocyte skin carcinomas (squamous cell carcinoma, basal cell carcinoma [BCC], Bowen disease [BD]) inflict significant morbidity and constitute a treatment challenge in renal transplant recipients (RTR). Immunocryosurgery has shown efficacy >95% in the treatment of BCC and BD in immunocompetent patients. The present study evaluated the safety, feasibility and efficacy, of immunocryosurgery in the treatment of BCC and BD in a series of RTR. During a 3-year period, biopsy-confirmed cases of BCC and BD were treated with a standard immunocryosurgery cycle (5 weeks daily imiquimod and a session of cryosurgery at day 14). Safety was evaluated by comparing graft function markers between immunocryosurgery treated RTR patients and matched controls. Ten BCC (8 nodular, 1 basosquamous, 1 superficial; diameter 6-14 mm; mean 9.2 mm) and nine BD disease lesions in nine patients (7 men, 2 women; age range: 54-70 years, mean: 62.1 years) were treated with immunocryosurgery and followed-up for two to 5 years. Five BCC were located on the "H area" of the face. No patient showed clinical or laboratory signs of transplant dysfunction during treatment or follow-up. Seven out of 10 BCC lesions cleared completely after one 5-week immunocryosurgery cycle, two cleared after repeat and intensified treatment cycles and one responded only partially (clearance rate: 90%). Seven out of nine BD lesions cleared after one 5-week immunocryosurgery cycle and one lesion after two cycles (clearance rate: 88.9%). In conclusion, immunocryosurgery is a safe, feasible and effective minimally invasive treatment alternative to standard surgical modalities for BCC and BD in RTR.
角质形成细胞皮肤癌（鳞状细胞癌、基底细胞癌[BCC]、鲍温病[BD]）在肾移植受者（RTR）中造成严重发病情况，构成治疗挑战。免疫冷冻手术在免疫功能正常的患者中治疗BCC和BD的疗效已显示超过95%。本研究评估了免疫冷冻手术治疗一系列RTR中BCC和BD的安全性、可行性和疗效。在3年期间，对经活检确诊的BCC和BD病例采用标准免疫冷冻手术周期进行治疗（5周每日使用咪喹莫特，并在第14天进行一次冷冻手术）。通过比较接受免疫冷冻手术治疗的RTR患者与匹配对照之间的移植功能标志物来评估安全性。对9例患者（7例男性，2例女性；年龄范围：54 - 70岁，平均：62.1岁）的10个BCC（8个结节状、1个基底鳞状、1个浅表性；直径6 - 14毫米；平均9.2毫米）和9个BD病损采用免疫冷冻手术治疗，并随访2至5年。5个BCC位于面部的“H区域”。在治疗或随访期间，没有患者出现移植功能障碍的临床或实验室体征。10个BCC病损中有7个在一个5周免疫冷冻手术周期后完全清除，2个在重复强化治疗周期后清除，1个仅部分缓解（清除率：90%）。9个BD病损中有7个在一个5周免疫冷冻手术周期后清除，1个在两个周期后清除（清除率：88.9%）。总之，对于RTR中的BCC和BD，免疫冷冻手术是一种安全、可行且有效的微创治疗选择，可替代标准手术方式。
