INTRODUCTION

Patient education, skin cancer screening, and early treatment intervention, comprise the essential components of patient care in transplant dermatology. Between 45 to 100% of transplant recipients are affected by skin disease. Cosmetic, infectious, and neoplastic skin changes may provoke anxiety and concern from patients. Patient education, beginning pretransplant and continued posttransplant, may help to lessen patient anxiety and facilitate the early diagnosis and treatment of skin disease. The goals of patient education in transplant dermatology are listed in Table 49.1.

PRETRANSPLANT EDUCATION

An important goal of patient education prior to organ transplantation is to assist the transplant candidate in developing an understanding of the broad categories of skin disease that may develop following organ transplantation. These include skin cancer, infections, and the skin changes associated with immunosuppressive medications (Table 49.2). A significant portion of patient education in transplant dermatology is devoted to the subject of skin cancer. Although all transplant candidates may receive counseling regarding skin cancer and prevention, additional information may be provided on a patient-by-patient basis according to the individual's own risk for skin cancer (Table 49.3). A patient's overall risk for developing skin cancer can be ascertained efficiently through use of brief questionnaires. These may be completed by patients in the waiting room and responses then used as a reference for subsequent patient education. For example, information regarding place of birth, as well as childhood, current and occupational sun exposure will provide an estimate of cumulative sun exposure.