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* Management:
o Regular checks with a Dermatologist
o Treatment of all warts – usually use cryotherapy
o Avoid sun exposure
* One major problem is the number of warts that some recipients develop – can number in the thousands
Dermatology IC at Hammersmith
Too Many Warts
* A number of our patients attend every 6 weeks and have >100 warts frozen
o Painful and time consuming
* Important to target all warts as you cannot predict which are potentially going to develop into skin cancers
* Imiquimod – cream that enhances immune systems ability to deal with viral infections
o used successfully in RTR without effects on the graft
Dermatology IC at Hammersmith
Skin Cancer and Renal Transplant Recipients
* In the normal population, the commonest type of skin cancer is the basal cell carcinoma ( basal cell carcinoma : squamous cell carcinoma is 10:1)
* In the renal transplant recipient, squamous cell carcinomas are 10X as common as basal cell carcinomas
* Squamous cell carcinomas are metastatic – can spread to other parts of the body – and this is increased with immunosuppression
Dermatology IC at Hammersmith
Skin Cancer and Renal Transplant Recipient
* Incidence of melanoma is greatly increased in the renal transplant recipient
* Melanoma is the most aggressive skin cancer seen in man
* These may arise from pre-existing moles or come up in normal skin
* Melanomas are often more aggressive in the immunosuppressed
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