Systemic and topical retinoids in the management of skin cancer in organ transplant recipients.

BACKGROUND: Nonmelanoma skin cancers are the most frequent malignancies in organ transplant patients. Patients who develop multiple new skin cancers may benefit from retinoid chemoprevention.

OBJECTIVE: The objective of this study was to advise on the use of retinoids in organ transplant recipients.

METHODS: A summary was performed of the existing literature regarding experience with retinoid chemoprevention for skin cancer in organ transplant patients.

RESULTS: Systemic retinoids, specifically acitretin, are effective in inhibiting tumor development in organ transplant patients. This effect is only present during therapy, however. Topical retinoids have some effect in the treatment of actinic keratoses.

CONCLUSIONS AND RECOMMENDATIONS: Systemic retinoids can be used for chemoprevention of skin cancer. For a good result, long-term treatment with acitretin is necessary. Side effects, however, limit the use of retinoid chemoprevention. It is advised that treatment be started at a low dose, and patients should be monitored regularly for triglyceride and cholesterol levels and transaminases.