Keratotic skin lesions and other risk factors are associated with skin cancer in organ-transplant recipients: a case-control study in The Netherlands, United Kingdom, Germany, France, and Italy

J Invest Dermatol. 2007 Jul;127(7):1647-56. doi: 10.1038/sj.jid.5700776. Epub 2007 Mar 22.


This study examines the association of keratotic skin lesions with the development of skin cancer in 915 solid organ-transplant recipients in five European countries. In a hospital-based case-control study, cases with squamous- and basal-cell carcinoma were compared with controls without skin cancer. Questionnaires, scrutiny of medical charts, and skin examination were delivered according to a standardized protocol. Keratotic skin lesions and viral warts were counted on different body sites. Keratotic skin lesions were strongly associated with an increased risk of squamous-cell carcinoma, with adjusted odds ratios of 4.1 (2.4;7.0) and 12.1 (6.1;24) for 1-49 and 50 and more keratotic skin lesions compared with no lesions, respectively. Keratotic skin lesions were also associated with basal-cell carcinoma with adjusted odds ratios of 2.9 (1.7;4.9) and 4.0 (1.7;9.2) for 1-49 and 50 and more lesions, respectively. Lighter skin types and painful sunburns were also significantly associated with an increased risk of squamous- and basal-cell carcinoma. Keratotic skin lesions are strongly associated with skin cancer and are, thus, an important clinical criterion for identifying those organ-transplant recipients at an increased risk of skin cancers who should be offered more intensive skin surveillance.

Publication types

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

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Basal Cell / epidemiology*
  • Carcinoma, Squamous Cell / epidemiology*
  • Case-Control Studies
  • Europe / epidemiology
  • Female
  • Humans
  • Keratosis / epidemiology*
  • Keratosis / pathology*
  • Life Style
  • Male
  • Middle Aged
  • Papillomavirus Infections / epidemiology
  • Risk Factors
  • Sex Characteristics
  • Skin Neoplasms / etiology*
  • Skin Pigmentation
  • Sunlight / adverse effects
  • Transplantation / adverse effects*