High frequency and diversity of cutaneous appendageal tumors in organ transplant recipients

J Am Acad Dermatol. 2003 Mar;48(3):401-8. doi: 10.1067/mjd.2003.97.


Background: Recipients of organ transplant who are immunosuppressed are at greatly increased risk of nonmelanoma skin cancers compared with the general population, but their risk of appendageal tumors is unknown.

Objective: Our aim was to conduct a systematic examination of cutaneous appendageal tumors arising in recipients of organ transplants compared with individuals who were immunocompetent (ICP).

Methods: We conducted a retrospective, clinicopathologic analysis of consecutive appendageal tumors arising in 650 recipients of organ transplants and in the general population of approximately 605,000 people served by our institution.

Results: Between 1993 and 1998, 231 appendageal tumors were identified in 211 individuals; 23 tumors were found in 21 of 650 patients undergoing transplant (3%), 10 in individuals with other immunosuppressive conditions, 3 in 2 patients with Muir-Torre syndrome, and 195 in 178 apparently ICP. In addition to the increased frequency of appendageal tumors among recipients of transplants, malignant tumors were overrepresented (43% of transplant tumors vs 4% in ICP; P <.0001) as were tumors of sebaceous origin (30% vs 6%; P <.0001).

Conclusions: Recipients of organ transplant who are immunosuppressed have a greatly increased risk of cutaneous appendageal tumors compared with apparently ICP. In addition, their tumors are more likely to be malignant and of sebaceous origin.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Biopsy, Needle
  • Carcinoma, Skin Appendage / epidemiology
  • Carcinoma, Skin Appendage / immunology
  • Carcinoma, Skin Appendage / pathology*
  • Case-Control Studies
  • Female
  • Follow-Up Studies
  • Graft Rejection
  • Graft Survival
  • Humans
  • Immunocompromised Host / immunology*
  • Immunohistochemistry
  • Incidence
  • Male
  • Middle Aged
  • Organ Transplantation / adverse effects*
  • Reference Values
  • Retrospective Studies
  • Risk Assessment
  • Sex Distribution
  • Skin Neoplasms / epidemiology
  • Skin Neoplasms / immunology
  • Skin Neoplasms / pathology*
  • Transplantation Immunology