Avaliação do câncer de pele não melanoma em receptores de transplante renal

Abstract

Introduction: Non-melanoma skin cancer (NMSC) is the most common malignancy post-transplantation, and diagnosis should be refined using more sensitive methods such as dermatoscopy. Objective: 1) To assess the prevalence of NMSC in renal transplant recipients (RTx); 2) To identify risk factors; 3) To compare the accuracy of dermatoscopy with histopathological results. Methods: A prospective study was conducted from January 2022 to January 2023. RTx (n=100) were randomly selected for clinical and dermatoscopic examination, and then divided into two groups: with NMSC (NMSC; n=39) and without NMSC (without NMSC; n=61). Possible variables associated with NMSC in both groups were analyzed. Results: During the study period, NMSC was diagnosed in 39% of RTx, at a rate of 3.25 cases per month. The most prevalent neoplasms were squamous cell carcinoma (SCC; 59%) and basal cell carcinoma (BCC; 41%). Factors associated with NMSC were: male gender (OR=2); age over 50 (OR=5.4); occupational sun exposure (OR=2.5); recreational sun exposure (OR=4.9); actinic keratosis (OR=6.5); family history of NMSC (OR=7.6); and induction with thymoglobulin (OR=2.4). The accuracy rate between clinical and dermatoscopic diagnoses and the final histological result after biopsy was 81.25% for suspected NMSC cases. Conclusions: NMSC occurred in 39% of evaluated RTx; family history and actinic keratosis were the main risk factors. Dermatoscopy diagnosed NMSC in 81%, thus we suggest its incorporation into routine evaluation.