Risk factors for skin carcinogenesis in immunosuppressed kidney transplant recipients

Immunosuppressed kidney transplant recipients have increased susceptibility to skin carcinogenesis, the incidence of skin cancer increasing with time following transplantation. In this study, 73 kidney transplant recipients surviving 7.8–12.7 yr following transplantation were investigated in order to identify risk factors associated with the development of skin cancer. The patients were treated with azathioprine and prednisone therapy. Thirty one (42%) developed skin cancer. Positive risk factors were an Anglo‐Saxon or Celtic ethnic origin, blue eyes, fair complexion, relative sensitivity to sunlight, and increasing age. Development of skin cancer also correlated positively with development of cancer of other organs and a lower number of acute rejection episodes involving the transplanted kidney. Factors with no association with skin cancer development were degree of sun exposure (occupational and leisure) following transplantation, history of verrucae vulgaris, or of skin infections with herpes simplex or zoster, cause of primary kidney failure, level of graft function, and cumulative azathioprine dosage.