Group leaders: Dr. Iris Ahronowitz and Dr. David Lee
Project summary:
The burden of skin disease in transplant patients has been substantiated by a growing body of literature. Due to their need for lifelong 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 in squamous cell carcinoma, 10-fold increases in basal cell carcinoma, and 3-fold increased rates of melanoma in these patients. Additionally, skin cancers in organ transplant recipients tend to be more aggressive, with higher rates of metastasis and higher mortality compared to non-transplant patients. Among organ transplant recipients, skin cancer is known to be increased in those of white race and older age, among other risk factors, however in general, non-white organ transplant recipients are underrepresented among the currently published literature on this subject. The only study to date that has focused on non-white organ transplant recipients did note a particularly increased risk for HPV-associated skin cancers in black patients arising in photoprotected areas, highlighting one of many potential unique characteristics and health needs of 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 implemented at many academic medical centers. This team proposes to formally initiate the process of building a multi-disciplinary team to create a clinical center for enhancing 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, they aim to provide a streamlined referral service for these patients for both routine screening and urgent evaluations for suspicious lesions or concerning rashes.
Additionally, they aim to build a research collaboration among these subspecialties to facilitate the ongoing study of our patient population. Initial research aims include characterizing the patient population we see, with particular attention to the unique features of our group (namely, a Hispanic-predominant transplant patient population), whose health circumstances have been under-represented and under-studied in the current medical literature. Subsequent goals include directed patient-education interventions to improve patient comprehension of their disease risks and adherence to preventive measures and self-skin examinations.
Learn more about their work:
- Alder BL, Smogorzewski J, Sierro T, Shauly O, Osipchuk D, Miller M, Mert M, Fong MW, Ganesh S, Han H, In GK, Maw TT, Smogozewski M, Hu J, Ngo B, Ahronowitz I. Skin cancer and dermatoses in a majority Hispanic population of solid organ transplant recipients. J Am Acad Dermatol. 2019 August 7. https://www.ncbi.nlm.nih.gov/pubmed/31400454