Book contents
- Frontmatter
- Contents
- List of Contributors
- Foreword by Daniel R. Salomon
- Foreword by Robin Marks
- Foreword by Kathy Schwab
- Preface
- Acknowledgments
- SECTION ONE TRANSPLANT DERMATOLOGY: AN EVOLVING DYNAMIC FIELD
- Section Two Transplant Medicine and Dermatology
- Section Three Pathogenic Factors in Transplant Dermatology
- Section Four Cutaneous Effects of Immunosuppressive Medications
- Section Five Infectious Diseases of the Skin in Transplant Dermatology
- Section Six Benign and Inflammatory Skin Diseases in Transplant Dermatology
- Section Seven Cutaneous Oncology in Transplant Dermatology
- Section Eight Special Scenarios in Transplant Cutaneous Oncology
- 32 Metastatic Squamous Cell Carcinoma in Organ Transplant Recipients
- 33 In-Transit Metastatic Squamous Cell Carcinoma in Organ Transplant Recipients
- 34 Metastatic Malignant Melanoma in Organ Transplant Recipients
- 35 Transplant Scalp: Severe Actinic Damage of the Scalp in Organ Transplant Recipients
- 36 Transplant Lip: Severe Actinic Damage of the Vermilion in Organ Transplant Recipients
- 37 Transplant Hands: Severe Actinic Damage of the Hands in Organ Transplant Recipients
- 38 Skin Cancer and Nevi in Pediatric Organ Transplant Recipients
- 39 Dermatologic Surgery in Organ Transplant Recipients
- 40 Radiation Therapy in Organ Transplant Recipients
- 41 Reduction of Immunosuppression for Transplant-Associated Skin Cancer
- 42 Systemic Retinoids for Prevention of Skin Cancer in Organ Transplant Recipients
- 43 Topical Treatment of Actinic Keratosis and Photodamage in Organ Transplant Recipients
- 44 Imiquimod Use in Organ Transplant Recipients
- 45 Photodynamic Therapy in Organ Transplant Recipients
- 46 Skin Cancer Prevention and Photoprotection in Organ Transplant Recipients
- 47 Skin Cancer Prior to Organ Transplantation or Organ Donation
- Section Nine Educational, Organizational, and Research Efforts in Transplant Dermatology
- Index
35 - Transplant Scalp: Severe Actinic Damage of the Scalp in Organ Transplant Recipients
from Section Eight - Special Scenarios in Transplant Cutaneous Oncology
Published online by Cambridge University Press: 18 January 2010
- Frontmatter
- Contents
- List of Contributors
- Foreword by Daniel R. Salomon
- Foreword by Robin Marks
- Foreword by Kathy Schwab
- Preface
- Acknowledgments
- SECTION ONE TRANSPLANT DERMATOLOGY: AN EVOLVING DYNAMIC FIELD
- Section Two Transplant Medicine and Dermatology
- Section Three Pathogenic Factors in Transplant Dermatology
- Section Four Cutaneous Effects of Immunosuppressive Medications
- Section Five Infectious Diseases of the Skin in Transplant Dermatology
- Section Six Benign and Inflammatory Skin Diseases in Transplant Dermatology
- Section Seven Cutaneous Oncology in Transplant Dermatology
- Section Eight Special Scenarios in Transplant Cutaneous Oncology
- 32 Metastatic Squamous Cell Carcinoma in Organ Transplant Recipients
- 33 In-Transit Metastatic Squamous Cell Carcinoma in Organ Transplant Recipients
- 34 Metastatic Malignant Melanoma in Organ Transplant Recipients
- 35 Transplant Scalp: Severe Actinic Damage of the Scalp in Organ Transplant Recipients
- 36 Transplant Lip: Severe Actinic Damage of the Vermilion in Organ Transplant Recipients
- 37 Transplant Hands: Severe Actinic Damage of the Hands in Organ Transplant Recipients
- 38 Skin Cancer and Nevi in Pediatric Organ Transplant Recipients
- 39 Dermatologic Surgery in Organ Transplant Recipients
- 40 Radiation Therapy in Organ Transplant Recipients
- 41 Reduction of Immunosuppression for Transplant-Associated Skin Cancer
- 42 Systemic Retinoids for Prevention of Skin Cancer in Organ Transplant Recipients
- 43 Topical Treatment of Actinic Keratosis and Photodamage in Organ Transplant Recipients
- 44 Imiquimod Use in Organ Transplant Recipients
- 45 Photodynamic Therapy in Organ Transplant Recipients
- 46 Skin Cancer Prevention and Photoprotection in Organ Transplant Recipients
- 47 Skin Cancer Prior to Organ Transplantation or Organ Donation
- Section Nine Educational, Organizational, and Research Efforts in Transplant Dermatology
- Index
Summary
INTRODUCTION
The management of skin cancer in organ transplant recipients (OTRs) represents a significant challenge. One anatomic area that presents distinct management difficulties is the scalp of transplant recipients. Diffuse precancerous and cancerous changes over the entire field of the scalp, known as “transplant scalp,” is very difficult to manage. Likewise, isolated aggressive skin cancer occurring on the scalp can exhibit aggressive behavior, and presents a different challenge.
EPIDEMIOLOGY
The incidence of diffuse scalp disease in the OTR is not well described. In an analysis of 1,069 cardiothoracic transplant recipients, 11.2% of patients developed nonlymphoid malignancies. Half of these malignancies were tumors of the head and neck with 96% being of cutaneous origin and 80% of those being squamous cell carcinoma (SCC). The scalp was the most commonly involved site, accounting for over 15% of head and neck tumors.
One particular characteristic that may predispose patients to the development of field disease of the scalp is androgenetic alopecia, especially if the hair loss preceded organ transplantation. In an 8-year population-based study of skin cancer in 1,558 renal transplant patients in Ireland, 622 posttransplant cutaneous malignancies were identified. Seventy-eight of these tumors were found on the scalp or neck of males, whereas only three were identified on the scalp or neck of females. This finding indicates that hair density may be a major factor in the development of scalp neoplasms in the transplant recipient.
- Type
- Chapter
- Information
- Skin Disease in Organ Transplantation , pp. 234 - 237Publisher: Cambridge University PressPrint publication year: 2008