Skin cancer in organ transplant recipients: Epidemiology, pathogenesis, and management

Journal of the American Academy of Dermatology

Volumn 47, Issue 1, 2002, Pages 1-20

  Berg, Daniel ^a   Otley, Clark C ^b  

^a UNIVERSITY OF WASHINGTON   (United States)

^b MAYO CLINIC   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

15 DEOXYSPERGUALIN; AZATHIOPRINE; BREQUINAR; CYCLOSPORIN A; IMMUNOSUPPRESSIVE AGENT; LEFLUNOMIDE; MIZORIBINE; MYCOPHENOLIC ACID 2 MORPHOLINOETHYL ESTER; OKT 3; PREDNISONE; RAPAMYCIN; TACROLIMUS;

CANCER RISK; CLINICAL FEATURE; CORRELATION ANALYSIS; DRUG MECHANISM; GRAFT REJECTION; HUMAN; IMMUNOSUPPRESSIVE TREATMENT; ORGAN TRANSPLANTATION; PREVALENCE; PRIORITY JOURNAL; REVIEW; RISK FACTOR; SKIN CANCER; SKIN CARCINOGENESIS; UNITED STATES;

EID: 0036657493     PISSN: 01909622     EISSN: None     Source Type: Journal    
DOI: 10.1067/mjd.2002.125579     Document Type: Article

References (144)

1. Transplant Patient DataSource (2000, February 16). Richmond, VA: United Network for Organ Sharing. Retrieved August 2, 2001 from the World Wide Web: http://www.patients. unos.org/data.htm.
2. Carpenter CB. Improving the success of organ transplantation [editorial]. N Engl J Med 2000;342:647-8.
3. Takemoto SK, Terasaki PI, Gjertson DW, Cecka JM. Twelve years' experience with national sharing of HLA-matched cadaveric kidneys for transplantation. N Engl J Med 2000;343:1078-84.
4. Hariharan S, Johnson CP, Bresnahan BA, Taranto SE, McIntosh MJ, Stablein D. Improved graft survival after renal transplantation in the United States, 1988 to 1996. N Engl J Med 2000;342: 605-12.
5. Edwards NM, Rajasinghe HA, John R, Chen JM, Itescu S, Mancini DM. Cardiac transplantation in over 1000 patients: a single institution experience from Columbia University. Clin Transpl 1999. p. 249-61.
6. Jain A, Khanna A, Molmenti EP, Rishi N, Fung JJ. Immunosuppressive therapy. Surg Clin North Am 1999;79:59-76.
7. US Renal Transplant Mycophenolate Mofetil Study Group. Mycophenolate mofetil in cadaveric renal transplantation. Am J Kidney Dis 1999;34:296-303.
8. Segoloni G, Bonomini V, Maresca MC, Arisi L, Gonzalez-Molina M, Tarantino A, et al. Tacrolimus is highly effective in both dual and triple therapy regimens following renal transplantation. Spanish and Italian Tacrolimus Study Group. Transpl Int 2000; 13(Suppl 1):S336-40.
9. Johnson C, Ahsan N, Gonwa T, Halloran P, Stegall M, Hardy M, et al. Randomized trial of tacrolimus (Prograf) in combination with azathioprine or mycophenolate mofetil versus cyclosporine (Neoral) with mycophenolate mofetil after cadaveric kidney transplantation. Transplantation 2000;69:834-41.
10. Miller J, Mendez R, Pirsch JD, Jensik SC. Safety and efficacy of tacrolimus in combination with mycophenolate mofetil (MMF) in cadaveric renal transplant recipients. FK506/MMF Dose-Ranging Kidney Transplant Study Group. Transplantation 2000;69:875-80.
11. Shell AG. Development of malignancy following renal transplantation in Australia and New Zealand. Transplant Proc 1992; 24:1275-9.
12. Penn I. Post-transplant malignancy: the role of immunosuppression. Drug Saf 2000;23:101-13.
13. Penn I. Cancers in renal transplant recipients. Adv Ren Replace Ther 2000;7:147-56.
14. Penn I, Brunson ME. Cancers after cyclosporine therapy. Transplant Proc 1988;20(Suppl 3):885-92.
15. Shell AG, Disney AP, Mathew TH, Amiss N. De novo malignancy emerges as a major cause of morbidity and late failure in renal transplantation. Transplant Proc 1993;25:1383-4.
16. Jensen P, Hansen S, Moller B, Leivestad T, Pfefer P, Geiran O, et al. Skin cancer in kidney and heart transplant recipients and different long-term immunosuppressive therapy regimens. J Am Acad Dermatol 1999;40:177-86.
17. Hartevelt MM, Bavinck JN, Kootte AM, Vermeer BJ, Vanden-broucke JP. Incidence of skin cancer after renal transplantation in The Netherlands. Transplantation 1990;49:506-9.
18. Bouwes Bavinck JN, Hardie DR, Green A, Cutmore S, MacNaught A, O'Sullivan B, et al. The risk of skin cancer in renal transplant recipients in Queensland, Australia. A follow-up study. Transplantation 1996;61:715-21.
19. Ong CS, Keogh AM, Kossard S, Macdonald PS, Spratt PM. Skin cancer in Australian heart transplant recipients. J Am Acad Dermatol 1999;40:27-34.
20. Naldi L, Fortina AB, Lovati S, Barba A, Gotti E, Tessari G, et al. Risk of nonmelanoma skin cancer in Italian organ transplant recipients. A registry-based study. Transplantation 2000;70:1479-84.
21. London NJ, Farmery SM, Will EJ, Davison AM, Lodge JP. Risk of neoplasia in renal transplant patients. Lancet 1995;346:403-6.
22. Marubayashi S, Tashiro H, Watanabe H, Fudaba Y, Hayamizu K, Ohdan H, et al. Study on eight patients with malignant tumors after renal transplantation. Hiroshima J Med Sci 2000;49:117-20.
23. Kishikawa H, Ichikawa Y, Yazawa K, Hanafusa T, Fukunishi T, Ebisui C, et al. Malignant neoplasm in kidney transplantation. Int J Urol 1998;5:521-5.
24. Lampros TD, Cobanoglu A, Parker F, Ratkovec R, Norman DJ, Hershberger R. Squamous and basal cell carcinoma in heart transplant recipients. J Heart Lung Transplant 1998;17:586-91.
25. Ferrandiz C, Fuente MJ, Ribera M, Bielsa I, Fernandez MT, Lauzurica R, et al. Epidermal dysplasia and neoplasia in kidney transplant recipients. J Am Acad Dermatol 1995;33:590-6.
26. Hardie IR, Strong RW, Hartley LC, Woodruff PW, Clunie GJ. Skin cancer in Caucasian renal allograft recipients living in a subtropical climate. Surgery 1980;87:177-83.
27. Jain AB, Yee LD, Nalesnik MA, Youk A, Marsh G, Reyes J, et al. Comparative incidence of de novo nonlymphoid malignancies after liver transplantation under tacrolimus using surveillance epidemiologic end result data. Transplantation 1998;66:1193-200.
28. Lindelof B, Sigurgeirsson B, Gabel H, Stern RS. Incidence of skin cancer in 5356 patients following organ transplantation. Br J Dermatol 2000;143:513-9.
29. Douds AC, Mellotte GJ, Morgan SH. Fatal Merkel-cell tumour (cutaneous neuroendocrine carcinoma) complicating renal transplantation. Nephrol Dial Transplant 1995;10:2346-8.
30. Penn I, First MR. Merkel's cell carcinoma in organ recipients: report of 41 cases. Transplantation 1999;68:1717-21.
31. Hafner J, Künzi W, Weinreich T. Malignant fibrous histiocytoma and atypical fibroxanthoma in renal transplant recipients. Dermatology 1999;198:29-32.
32. Wehrli BM, Janzen DL, Shokeir O, Masri BA, Byrne SK, O'Connell JX. Epithelioid angiosarcoma arising in a surgically constructed arteriovenous fistula: a rare complication of chronic immunosuppression in the setting of renal transplantation. Am J Surg Pathol 1998;22:1154-9.
33. Kibe Y, Kishimoto S, Katoh N, Yasuno H, Yasumura T, Oka T. Angiosarcoma of the scalp associated with renal transplantation. Br J Dermatol 1997;136:752-6.
34. Veness MJ, Quinn DI, Ong CS, Keogh AM, Macdonald PS, Cooper SG, et al. Aggressive cutaneous malignancies following cardiothoracic transplantation: the Australian experience. Cancer 1999;85:1758-64.
35. Euvrard S, Kanitakis J, Pouteil-Noble C, Disant F, Dureau G, Finaz de Villaine J, et al. Aggressive squamous cell carcinomas in organ transplant recipients. Transplant Proc 1995;27:1767-8.
36. Adamson R, Obispo E, Dychter S, Dembitsky W, Moreno-Cabral R, Jaski B, et al. High incidence and clinical course of aggressive skin cancer in heart transplant patients: a single-center study. Transplant Proc 1998;30:1124-6.
37. Pollard JD, Hanasono MM, Mikulec AA, Le QT, Terris DJ. Head and neck cancer in cardiothoracic transplant recipients. Laryngoscope 2000;110:1257-61.
38. Glover MT, Niranjan N, Kwan JT, Leigh IM. Non-melanoma skin cancer in renal transplant recipients: the extent of the problem and a strategy for management. Br J Plast Surg 1994;47:86-9.
39. Penn I. Posttransplant malignancies in pediatric organ transplant recipients. Transplant Proc 1994;26:2763-5.
40. Penn I. Malignant melanoma in organ allograft recipients. Transplantation 1996;61:274-8.
41. Ramsay HM, Fryer AA, Reece S, Smith AG, Harden PN. Clinical risk factors associated with nonmelanoma skin cancer in renal transplant recipients. Am J Kidney Dis 2000;36:167-76.
42. Webb MC, Compton F, Andrews PA, Koffman CG. Skin tumours posttransplantation: a retrospective analysis of 28 years' experience at a single centre. Transplant Proc 1997;29:828-30.
43. Dyall-Smith D, Ross JB. Cutaneous malignancies in renal transplant recipients from Nova Scotia, Canada. Australas J Dermatol 1995;36:79-82.
44. Roeger LS, Sheil AGR, Disney APS, Mathew TH, Amiss N. Risk factors associated with the development of squamous cell carcinomas in immunosuppressed renal transplant recipients. Clin Transplant 1992;6:202-11.
45. Jensen P, Hansen S, Moller B, Leivestad T, Pfeffer P, Fauchald P. Are renal transplant recipients on CsA-based immunosuppressive regimens more likely to develop skin cancer than those on azathioprine and prednisolone? Transplant Proc 1999;31:1120.
46. Ducloux D, Carron PL, Rebibou JM, Aubin F, Fournier V, Bresson-Vautrin C, et al. CD4 lymphocytopenia as a risk factor for skin cancers in renal transplant recipients. Transplantation 1998;65:1270-2.
47. Penn I. The effect of immunosuppression on pre-existing cancers. Transplantation 1993;55:742-7.
48. Euvrard S, Kanitakis J, Pouteil-Noble C, Dureau G, Touraine JL, Faure M, et al. Comparative epidemiologic study of premalignant and malignant epithelial cutaneous lesions developing after kidney and heart transplantation. J Am Acad Dermatol 1995;33:222-9.
49. Gjersvik P, Hansen S, Moller B, Leivestad T, Geiran O, Simonsen S, et al. Are heart transplant recipients more likely to develop skin cancer than kidney transplant recipients? Transpl Int 2000; 13(Suppl 1):S380-1.
50. Fortina AB, Caforio AL, Piaserico S, Alaibac M, Tona F, Feltrin G, et al. Skin cancer in heart transplant recipients: frequency and risk factor analysis. J Heart Lung Transplant 2000;19:249-55.
51. Frezza EE, Fung JJ, van Thiel DH. Non-lymphoid cancer after liver transplantation. Hepatogastroenterology 1997;44:1172-81.
52. Penn I. Posttransplantation de novo tumors in liver allograft recipients. Liver Transpl Surg 1996;2:52-9.
53. Kelly DM, Emre S, Guy SR, Miller CM, Schwartz ME, Sheiner PA. Liver transplant recipients are not at increased risk for nonlymphoid solid organ tumors. Cancer 1998;83:1237-43.
54. Espana A, Redondo P, Fernandez AL, Zabala M, Herreros J, Llorens R, et al. Skin cancer in heart transplant recipients. J Am Acad Dermatol 1995;32:458-65.
55. Bouwes Bavinck JN, Vermeer BJ, van der Woude FJ, Vandenbroucke JP, Schreuder GM, Thorogood J, et al. Relation between skin cancer and HLA antigens in renal-transplant reciplents. N Engl J Med 1991;325:843-8.
56. Czarnecki D, Watkins F, Leahy S, Dyall-Smith D, Levis A, Nicholson I, et al. Skin cancers and HLA frequencies in renal transplant recipients. Dermatology 1992;185:9-11.
57. Hojo M, Morimoto T, Maluccio M, Asano T, Morimoto K, Lagman M, et al. Cyclosporine induces cancer progression by a cell-autonomous mechanism. Nature 1999;397:530-4.
58. Kelly GE, Meikle W, Sheil AG. Effects of immunosuppressive therapy on the induction of skin tumors by ultraviolet irradiation in hairless mice. Transplantation 1987;44:429-34.
59. Servilla KS, Burnham DK, Daynes RA. Ability of cyclosporine to promote the growth of transplanted ultraviolet radiation-induced tumors in mice. Transplantation 1987;44:291-5.
60. Boyle J, MacKie RM, Briggs JD, Junor BJ, Aitchison TC. Cancer, warts, and sunshine in renal transplant patients. A case-control study. Lancet 1984;1:702-5.
61. Moore DE, Sik RH, Bilski P, Chignell CF, Reszka KJ. Photochemical sensitization by azathioprine and its metabolites. Part 3. A direct EPR and spin-trapping study of light-induced free radicals from 6-mercaptopurine and its oxidation products. Photochem Photobiol 1994;60:574-81.
62. Lennard L, Thomas S, Harrington CI, Maddocks JL. Skin cancer in renal transplant recipients is associated with increased concentrations of 6-thioguanine nucleotide in red blood cells. Br J Dermatol 1985;113:723-9.
63. Schmidt R, Stippel D, Schmitz-Rixen T, Pollok M. Tumors after renal transplantation. Urol Int 1996;57:21-6.
64. Hiesse C, Larue JR, Kriaa F, Blanchet P, Bellamy J, Benoit G, et al. Incidence and type of malignancies occurring after renal transplantation in conventionally and in cyclosporine-treated recipients: single-center analysis of a 20-year period in 1600 patients. Transplant Proc 1995;27:2450-1.
65. Shuttleworth D, Marks R, Griffin PJ, Salaman JR. Epidermal dysplasia and cyclosporine therapy in renal transplant patients: a comparison with azathioprine. Br J Dermatol 1989;120:551-4.
66. Blohme I, Larko O. No difference in skin cancer incidence with or without cyclosporine-a 5-year perspective. Transplant Proc 1992;24:313.
67. Gruber SA, Gillingham K, Sothern RB, Stephanian E, Matas AJ, Dunn DL. De novo cancer in cyclosporine-treated and non-cyclosporine-treated adult primary renal allograft recipients. Clin Transplant 1994;8:388-95.
68. Jonas S, Rayes N, Neumann U, Neuhaus R, Bechstein WO, Guckelberger O, et al. De novo malignancies after liver transplantation using tacrolimus-based protocols or cyclosporine-based quadruple immunosuppression with an interleukin-2 receptor antibody or antithymocyte globulin. Cancer 1997;80:1141-50.
69. Glover MT, Deeks JJ, Raftery MJ, Cunningham J, Leigh IM. Immunosuppression and risk of non-melanoma skin cancer in renal transplant recipients [letter]. Lancet 1997;349:398.
70. Confavreux C, Saddler P, Grimaud J, Moreau T, Adeleine P, Aimard G. Risk of cancer from azathioprine therapy in multiple sclerosis: a case-control study. Neurology 1996;46:1607-12.
71. Bavinck JN, De Boer A, Vermeer BJ, Hartevelt MM, van der Woude FJ, Claas FH, et al. Sunlight, keratotic skin lesions and skin cancer in renal transplant recipients. Br J Dermatol 1993; 129:242-9.
72. Kripke ML. Ultraviolet radiation and immunology: something new under the sun-presidential address. Cancer Res 1994;54: 6102-5.
73. Parrish JA. Ultraviolet radiation affects the immune system. Pediatrics 1983;71:129-33.
74. Naylor MF, Boyd A, Smith DW, Cameron GS, Hubbard D, Neldner KH. High sun protection factor sunscreens in the suppression of actinic neoplasia. Arch Dermatol 1995;131:170-5.
75. Kiviat NB. Papillomaviruses in non-melanoma skin cancer: epidemiological aspects. Semin Cancer Biol 1999;9:397-403.
76. Gibson GE, O'Grady A, Kay EW, Leader M, Murphy GM. Langerhans cells in benign, premalignant and malignant skin lesions of renal transplant recipients and the effect of retinoid therapy. J Eur Acad Dermatol Venereol 1998;10:130-6.
77. Jackson S, Storey A. E6 proteins from diverse cutaneous HPV types inhibit apoptosis in response to UV damage. Oncogene 2000;19:592-8.
78. Purdie KJ, Pennington J, Proby CM, Khalaf S, de Villiers EM, Leigh IM, et al. The promoter of a novel human papillomavirus (HPV77) associated with skin cancer displays UV responsiveness, which is mediated through a consensus p53 binding sequence. EMBO J 1999;18:5359-69.
79. Forslund O, Antonsson A, Nordin P, Stenquist B, Hansson BG. A broad range of human papillomavirus types detected with a general PCR method suitable for analysis of cutaneous tumours and normal skin. J Gen Virol 1999;80:2437-43.
80. de Villiers EM. Human papillomavirus infections in skin cancers. Biomed Pharmacother 1998;52:26-33.
81. Boxman IL, Mulder LH, Russell A, Bouwes Bavinck JN, Green A, Ter Schegget J. Human papillomavirus type 5 is commonly present in immunosuppressed and immunocompetent individuals. Br J Dermatol 1999;141:246-9.
82. Berkhout RJ, Bouwes Bavinck JN, ter Schegget J. Persistence of human papillomavirus DNA in benign and (pre)malignant skin lesions from renal transplant recipients. J Clin Microbiol 2000; 38:2087-96.
83. de Jong-Tieben LM, Berkhout RJ, ter Schegget J, Vermeer BJ, de Fijter JW, Bruijn JA, et al. The prevalence of human papillomavirus DNA in benign keratotic skin lesions of renal transplant recipients with and without a history of skin cancer is equally high: a clinical study to assess risk factors for keratotic skin lesions and skin cancer. Transplantation 2000;69:44-9.
84. Boxman IL, Russell A, Mulder LH, Bavinck JN, Schegget JT, Green A. Case-control study in a subtropical Australian population to assess the relation between non-melanoma skin cancer and epidermodysplasia verruciformis human papillomavirus DNA in plucked eyebrow hairs. The Nambour Skin Cancer Prevention Study Group. Int J Cancer 2000;86:118-21.
85. Harwood CA, Surentheran T, McGregor JM, Spink PJ, Leigh IM, Breuer J, et al. Human papillomavirus infection and non-melanoma skin cancer in immunosuppressed and immunocompetent individuals. J Med Virol 2000;61:289-97.
86. Shamanin V, zur Hausen H, Lavergne D, Proby CM, Leigh IM, Neumann C, et al. Human papillomavirus infections in non-melanoma skin cancers from renal transplant recipients and nonimmunosuppressed patients. J Natl Cancer Inst 1996;88: 802-11.
87. Baum A, Cohen L. Successful behavioral interventions to prevent cancer: the example of skin cancer. Annu Rev Public Health 1998;19:319-33.
88. Melia J, Pendry L, Eiser JR, Harland C, Moss S. Evaluation of primary prevention initiatives for skin cancer: a review from a UK perspective. Br J Dermatol 2000;143:701-8.
89. Robinson JK, Rademaker AW, Sylvester JA, Cook B. Summer sun exposure: knowledge, attitudes, and behaviors of Midwest adolescents. Prev Med 1997;26:364-72.
90. Robinson JK. Behavior modification obtained by sun protection education coupled with removal of a skin cancer. Arch Dermatol 1990;126:477-81.
91. Cowen EW, Billingsley EM. Awareness of skin cancer by kidney transplant patients. J Am Acad Dermatol 1999;40:697-701.
92. Seukeran DC, Newstead CG, Cunliffe WJ. The compliance of renal transplant recipients with advice about sun protection measures. Br J Dermatol 1998;138:301-3.
93. Butt A, Roberts DL. Renal transplant recipients and protection from sun: need for education. Lancet 1997;349:179-80.
94. Otley CC. Organization of a specialty clinic to optimize the care of organ transplant recipients at risk for skin cancer. Dermatol Surg 2000;26:709-12.
95. Levine N. Role of retinoids in skin cancer treatment and prevention. J Am Acad Dermatol 1998;39(Suppl):S62-6.
96. DiGiovanna JJ. Retinoid chemoprevention in the high-risk patient. J Am Acad Dermatol 1998;39(Suppl):S82-5.
97. Kraemer KH, DiGiovanna JJ, Moshell AN, Tarone RE, Peck GL. Prevention of skin cancer in xeroderma pigmentosum with use of oral isotretinoin. N Engl J Med 1988;318:1633-7.
98. Kraemer KH, DiGiovanna JJ, Peck GL. Chemoprevention of skin cancer in xeroderma pigmentosum. J Dermatol 1992;19:715-8.
99. Levine N, Moon TE, Cartmel B, Bangert JL, Rodney S, Dong Q, et al. Trial of retinol and isotretinoin in skin cancer prevention: a randomized, double-blind, controlled trial. Southwest Skin Cancer Prevention Study Group. Cancer Epidemiol Biomarkers Prev 1997;6:957-61.
100. Tangrea JA, Edwards BK, Taylor PR, Hartman AM, Peck GL, Salasche SJ, et al. Long-term therapy with low-dose isotretinoin for prevention of basal cell carcinoma: a multicenter clinical trial. Isotretinoin-Basal Cell Carcinoma Study Group. J Natl Cancer Inst 1992;84:328-32.
101. Moon TE, Levine N, Cartmel B, Bangert JL, Rodney S, Dong Q, et al. Effect of retinol in preventing squamous cell skin cancer in moderate-risk subjects: a randomized, double-blind, controlled trial. Southwest Skin Cancer Prevention Study Group. Cancer Epidemiol Biomarkers Prev 1997;6:949-56.
102. Bavinck JN, Tieben LM, Van der Woude FJ, Tegzess AM, Hermans J, ter Schegget J, et al. Prevention of skin cancer and reduction of keratotic skin lesions during acitretin therapy in renal transplant recipients: a double-blind, placebo-controlled study. J Clin Oncol 1995;13:1933-8.
103. McKenna DB, Murphy GM. Skin cancer chemoprophylaxis in renal transplant recipients: 5 years of experience using lowdose acitretin. Br J Dermatol 1999;140:656-60.
104. McKerrow KJ, MacKie RM, Lesko MJ, Pearson C. The effect of oral retinoid therapy on the normal human immune system. Br J Dermatol 1988;119:313-20.
105. Bellman BA, Eaglstein WH, Miller J. Low dose isotretinoin in the prophylaxis of skin cancer in renal transplant patients. Transplantation 1996;61:173.
106. Shuttleworth D, Marks R, Griffin PJ, Salaman JR. Treatment of cutaneous neoplasia with etretinate in renal transplant recipients. Q J Med 1988;68:717-25.
107. Rook AH, Jaworsky C, Nguyen T, Grossman RA, Wolfe JT, Witmer WK, et al. Beneficial effect of low-dose systemic retinoid in combination with topical tretinoin for the treatment and prophylaxis of premalignant and malignant skin lesions in renal transplant recipients. Transplantation 1995;59:714-9.
108. Odom R. Managing actinic keratoses with retinoids. J Am Acad Dermatol 1998;39(Suppl):S74-8.
109. Thorne EG. Long-term clinical experience with a topical retinoid. old. Br J Dermatol 1992;127(Suppl 41):31-6.
110. Euvrard S, Verschoore M, Touraine JL, Dureau G, Cochat P, Czernielewski J, et al. Topical retinoids for warts and keratoses in transplant recipients. Lancet 1992;340:48-9.
111. Otley CC, Coldiron BM, Stasko T, Goldman GD. Decreased skin cancer after cessation of therapy with transplant-associated immunosuppressants. Arch Dermatol 2001;137:459-63.
112. Dantal J, Hourmant M, Cantarovich D, Giral M, Blancho G, Dreno B, et al. Effect of long-term immunosuppression in kidney-graft recipients on cancer incidence: randomised comparison of two cyclosporin regimens. Lancet 1998;351:623-8.
113. Ramos HC, Reyes J, Abu-Elmagd K, Zeevi A, Reinsmoen N,Tzakis A, et al. Weaning of immunosuppression in long-term liver transplant recipients. Transplantation 1995;59:212-7.
114. Mazariegos GV, Reyes J, Marino IR, Demetris AJ, Flynn B, Irish W, et al. Weaning of immunosuppression in liver transplant recipients. Transplantation 1997;63:243-9.
115. Tejani A, Sullivan EK. Higher maintenance cyclosporine dose decreases the risk of graft failure in North American children: a report of the North American Pediatric Renal Transplant Cooperative Study. J Am Soc Nephrol 1996;7:550-5.
116. Johnson EM, Canafax DM, Gillingham K, Schmidt W, Pandian K, Najarian JS, et al. Do early cyclosporine levels affect the incidence of acute rejection in renal transplant recipients? Transplant Proc 1996;28:879.
117. Schroeder TJ, Hariharan S, First MR. Variations in bioavailability of cyclosporine and relationship to clinical outcome in renal transplant subpopulations. Transplant Proc 1995;27:837-9.
118. Sandborn WJ, Hay JE, Porayko MK, Gores GJ, Steers JL, Krom RA, et al. Cyclosporine withdrawal for nephrotoxicity in liver transplant recipients does not result in sustained improvement in kidney function and causes cellular and ductopenic rejection. Hepatology 1994;19:925-32.
119. Rowe DE, Carroll RJ, Day CL Jr. Prognostic factors for local recurrence, metastasis, and survival rates in squamous cell carcinoma of the skin, ear, and lip. Implications for treatment modality selection. J Am Acad Dermatol 1992;26:976-90.
120. Nelson BR, Fader DJ, Gillard M, Baker SR, Johnson TM. The role of dermabrasion and chemical peels in the treatment of patients with xeroderma pigmentosum. J Am Acad Dermatol 1995;32:623-6.
121. Johnson TM, Rowe DE, Nelson BR, Swanson NA. Squamous cell carcinoma of the skin (excluding lip and oral mucosa). J Am Acad Dermatol 1992;26:467-84.
122. Epstein E, Epstein NN, Bragg K, Linden G. Metastases from squamous cell carcinomas of the skin. Arch Dermatol 1968;97: 245-51.
123. Carlson GW, Murray DR, Greenlee R, Alazraki N, Fry-Spray C, Poole R, et al. Management of malignant melanoma of the head and neck using dynamic lymphoscintigraphy and gamma probe-guided sentinel lymph node biopsy. Arch Otolaryngol Head Neck Surg 2000;126:433-7.
124. Jackson GL, Ballantyne AJ. Role of parotidectomy for skin cancer of the head and neck. Am J Surg 1981;142:464-9.
125. Pacella J, Ashby M, Ainslie J, Minty C. The role of radiotherapy in the management of primary cutaneous neuroendocrine tumors (Merkel cell or trabecular carcinoma): experience at the Peter MacCallum Cancer Institute (Melbourne, Australia). Int J Radiat Oncol Biol Phys 1988;14:1077-84.
126. O'Connor WJ, Roenigk RK, Brodland DG. Merkel cell carcinoma. Comparison of Mohs micrographic surgery and wide excision in eighty-six patients. Dermatol Surg 1997;23:929-33.
127. Gollard R, Weber R, Kosty MP, Greenway HT, Massullo V, Humberson C. Merkel cell carcinoma: review of 22 cases with surgical, pathologic, and therapeutic considerations. Cancer 2000; 88:1842-51.
128. Snow SN, Larson PO, Hardy S, Bentz M, Madjar D, Landeck A, et al. Merkel cell carcinoma of the skin and mucosa: report of 12 cutaneous cases with 2 cases arising from the nasal mucosa. Dermatol Surg 2001;27:165-70.
129. Lawenda BD, Thiringer JK, Foss RD, Johnstone PA. Merkel cell carcinoma arising in the head and neck: optimizing therapy. Am J Clin Oncol 2001;24:35-42.
130. Duker I, Starz H, Bachter D, Balda BR. Prognostic and therapeutic implications of sentinel lymphonodectomy and S-staging in Merkel cell carcinoma. Dermatology 2001;202:225-9.
131. Besnard V, Euvrard S, Kanitakis J, Mion F, Boillot O, Frances C, et al. Kaposi's sarcoma after liver transplantation. Dermatology 1996;193:100-4.
132. Weber RS, Lippman SM, McNeese MD. Advanced basal and squamous cell carcinomas of the skin of the head and neck. In: Jacobs C, editor. Carcinomas of the head and neck: evaluation and management. Boston: Kluwer Academic Publishers; 1990. p. 61-81.
133. Shimm DS. Parotid lymph node metastases from squamous cell carcinoma of the skin. J Surg Oncol 1988;37:56-9.
134. Taylor BW Jr, Brant TA, Mendenhall NP, Mendenhall WM, Cassisi NJ, Stringer SP, et al. Carcinoma of the skin metastatic to parotid area lymph nodes. Head Neck 1991;13:427-33.
135. Cassisi NJ, Dickerson DR, Million RR. Squamous cell carcinoma of the skin metastatic to parotid nodes. Arch Otolaryngol 1978; 104:336-9.
136. Leemans CR, Chiesa F, Tradati N, Snow GB. Messages from completed randomized trials in head and neck cancer. Eur J Surg Oncol 1997;23:469-76.
137. Lippman SM, Kalvakolanu DV, Lotan R. Retinoids and interferons in non-melanoma skin cancer. J Investig Dermatol Symp Proc 1996;1:219-22.
138. Lippman SM, Parkinson DR, Itri LM, Weber RS, Schantz SP, Ota DM, et al. 13-cis-retinoic acid and interferon alpha-2a: effective combination therapy for advanced squamous cell carcinoma of the skin. J Natl Cancer Inst 1992;84:235-41.
139. Davis CL, Wood BL, Sabath DE, Joseph JS, Stehman-Breen C, Broudy VC. Interferon-alpha treatment of posttransplant lymphoproliferative disorder in recipients of solid organ transplants. Transplantation 1998;66:1770-9.
140. Scholtens RE, van Zuuren EJ, Posma AN. Treatment of recurrent squamous cell carcinoma of the hand in immunosuppressed patients. J Hand Surg [Am] 1995;20:73-6.
141. van Zuuren EJ, Posma AN, Scholtens RE, Vermeer BJ, van der Woude FJ, Bouwes Bavinck JN. Resurfacing the back of the hand as treatment and prevention of multiple skin cancers in kidney transplant recipients. J Am Acad Dermatol 1994;31: 760-4.
142. Holmkvist KA, Roenigk RK. Squamous cell carcinoma of the lip treated with Mohs micrographic surgery: outcome at 5 years. J Am Acad Dermatol 1998;38:960-6.
143. Kirk AD, Harlan DM, Armstrong NN, Davis TA, Dong Y, Gray GS, et al. CTLA4-Ig and anti-CD40 ligand prevent renal allograft rejection in primates. Proc Natl Acad Sci U S A 1997;94: 8789-94.
144. Ben-Hur H, Ben-Meir A, Hagay Z, Berman V, Schwartsburd B, Gurevich P, et al. Tumor-preventive effects of the soluble p53 antigen on chemically-induced skin cancer in mice. Anticancer Res 1998;18:4237-41.