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A Survey Analysis of the Frequency of Dermatologic Monitoring in Transplant Patients
EP27151
Poster Title: A Survey Analysis of the Frequency of Dermatologic Monitoring in Transplant Patients
Submitted on 08 Feb 2018
Author(s): Leigh Hatch, BS; Douglas Laurain, MD; Ambuj Kumar, MD; Erfon Ekhlassi, MD; Nishit Patel, MD
Affiliations: University of South Florida Morsani College of Medicine
This poster was presented at USF Health Research Day 2018
Poster Views: 455
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Poster Information
Abstract: Background:
Skin cancers are the most common cancers in patients who have received a solid organ transplant. The risk of developing skin cancer is significantly increased in the transplant patient compared to the average population, likely due to their highly immunosuppressive drug regimens. Because of this increase in skin cancer risk, it is extremely important for transplant patients to receive regular and thorough dermatologic monitoring.

Objective and Hypothesis:
The objective of this study is first to better understand if transplant patients are seeing dermatologists on a regular basis, if at all. A second objective is to compare these dermatologic monitoring rates between patients who received transplants in 2014, the year before the induction of a transplant-specific dermatology clinic at Tampa General Hospital (TGH), and transplant patients from 2016 after the start of the clinic. We hypothesize that transplant patients are seeing dermatologists at higher rates after the opening of a transplant-specific dermatology clinic.

Methods:
453 Tampa General Hospital transplant patients split between the years 2014 (228) and 2016 (225) were mailed survey questionnaires with questions about their dermatologic health and monitoring. Data was collected from the surveys and was analyzed using Statistical Analysis Software (SAS). Variables such as skin cancer risk and sunscreen compliance were analyzed and compared between patients who received transplants in 2014 and 2016, representing the years before and after the induction of the transplant-specific dermatology clinic.

Results:
Out of the 125 participants, 67 were 2014 transplant recipients and 58 were 2016 transplant recipients. The mean age of all participants was 61.02 years. Of the patients who received a transplant in 2014 (Pre-clinic), 62.7% report currently seeing a dermatologist. In contrast, 77.6% of patients who received a transplant in 2016 after the opening of the transplant dermatology clinic report that they regularly see a dermatologist (OR = 2.060). When patients were further stratified based on their risk of developing skin cancer, patients designated “high risk” were consistently receiving dermatologic monitoring at higher rates in the 2016 transplant group.

Conclusion:
Because all transplant patients are at risk for developing skin cancer at a significantly higher rate than the average population, it is imperative that they have access to regular skin cancer screenings. According to the results from the survey, transplant patients are receiving this dermatologic monitoring at a much higher rate after the opening of a TGH transplant-specific dermatology. Our initial data results lead to the conclusion that more of these clinics should open to improve access to skin cancer monitoring for this vulnerable population.
Summary: Transplant patients are at high risk for developing skin cancers due to highly immunosuppressive drug regimens. A retrospective survey was sent to the Tampa General Hospital transplant population to better understand if these patients are getting the necessary dermatologic monitoring.References: Kasiske BL, Snyder JJ, Gilbertson DT, Wang C. Cancer after kidney transplantation in the United States. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 2004;4(6):905-913.
Bernat Garcia J, Morales Suarez-Varela M, Vilata JJ, Marquina A, Pallardo L, Crespo J. Risk factors for non-melanoma skin cancer in kidney transplant patients in a Spanish population in the Mediterranean region. Acta dermato-venereologica. 2013;93(4):422-427.
Ismail F, Mitchell L, Casabonne D, et al. Specialist dermatology clinics for organ transplant recipients significantly improve compliance with photoprotection and levels of skin cancer awareness. Br J Dermatol. 2006;155(5):916–925.
Zwald FO, Brown M. Skin cancer in solid organ transplant recipients: advances in therapy and management. Part I. Epidemiology of skin cancer in solid organ transplant recipients. J Am Acad Dermatol 2011; 65: 253–261.
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