The burden of skin disease in transplant patients has been substantiated by a growing body of literature. Due to their need fo rlifelong immunosuppression to prevent graft rejection, transplant patients are at risk for a variety of cutaneous complications including skin cancers and infections. Skin cancer represents the most common cancer overall in solid organ transplant recipients, with increased rates of at least 65-fold of squamous cell carcinoma, 10-fold increases in basal cell carcinoma, and 3-fold increased rates of melanoma in these patients. The need for multidisciplinary medical teams to provide optimal care and skin cancer prevention education to organ transplant patients is well known, and has already been successfully impelemnted at many academic medical centers.

We plan to formally intiate the process of building a multi-disciplinary team to create a clinical center for enhnancing the skin health of post-transplant patients. The USC High Risk Skin Disease Clinic will be a full-service dermatology and dermatologic surgery clinic designed to serve all USC Keck Medical Center patients who are recipients of solid organ transplants. Through coordination with the divisions of Hepatology, Cardiology, Nephrology and Pulmonology, we aim to provide a streamlined referral service for these patients for both routine screening and urgent evaluations for suspicious lesions or concerning rashes. In order to facilitate a strong, thriving collaboration between the various stakeholders in this endeavor, it will be essential to lay the groundwork for open, clear and productive communication between the various medical disciplines and personnel. We propose to begin building this relationship through in-person quarterly meetings, and the use of interim "virtual" communication via the HIPAA-compliant web-based application Doximity (Doximity, San Francisco, CA) to allow frequent communication about questions of patient management, clinic logistics, and research.

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