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Open Access Publications from the University of California

Scholarly Works (43 results)

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Dermatology Online Journal, Volume 22, Issue 9 (2016)

BackgroundSkin cancer is the most common malignancy occurring after organ transplantation. Although previous research has reported an increased risk of skin cancer in solid organ transplant recipients (OTR), no study has estimated the post-transplant population-based incidence in the US. The objective of this study is to determine the incidence and evaluate the predictors of post-transplant skin cancer, including squamous cell carcinoma (SCC), melanoma (MM), and Merkel cell carcinoma (MCC) in a cohort of US OTR receiving a primary transplant in 2003 or 2008.

MethodsDesign: A multi-center retrospective cohort study with 5- and 10-year follow-up periods.Setting: The Transplant Skin Cancer Network (TSCN) comprises 26 transplant centers across the US.Participants: Adult recipients of a primary transplant performed at 26 centers in 2003 or 2008 identified through the Organ Procurement and Transplantation Network (OPTN) database (N=10,649) were selected. Recipients of all organs except intestine were included.Main outcome and measurements: Skin cancer outcomes were determined through detailed medical record review. Data on predictors were obtained from the OPTN database. The incidence rates (IR) for post-transplant skin cancer overall and for SCC, MM, and MCC were calculated per 100,000 person-years. Potential risk factors for post-transplant skin cancer were tested using multivariate Cox regression analysis to yield adjusted hazard ratios (HR).

ResultsThere were 10,649 organ transplant recipients that contributed 59,923 years of follow-up. The IR for post-transplant skin cancer overall was 1408 per 100,000 person-years. The specific subtype rates for SCC, MM, and MCC were 1328, 122, and 4 per 100,000 person-years, respectively. The statistically significant risk factors for post-transplant skin cancer were: pre- transplant skin cancer (HR 4.69, 95% confidence interval [CI] 3.26-6.73) male gender (HR 1.56, 95% CI 1.34-1.81), white race (HR 9.04, 95% CI 6.20-13.18), age at transplant ≥50 (HR 2.77, 95% CI 2.20-3.48), and being transplanted in 2008 vs. 2003 (HR 1.53, 95% CI 1.22-1.94).

ConclusionPost-transplant skin cancer is common, with elevated risk imparted by increased age, white race, male gender, and thoracic organ transplantation. Understanding the risk factors for post-transplant skin cancer is fundamental to targeted screening and prevention in this high-risk population.

    Cover page: Trends of skin cancer incidence following transplantation in the United StatesCreative Commons 'BY-NC-ND' version 4.0 license
    • Article
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    UC San Francisco Previously Published Works (2014)
      • Article
      • Peer Reviewed
      UC San Francisco Previously Published Works (2018)
      Veterans with skin cancer have seen improved access to Mohs micrographic surgery over the past 10 years, yet the challenges of travel distance and care coordination remain.
        Cover page: Mohs Micrographic Surgery in the Veterans Health Administration.
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        • Peer Reviewed
        UC San Francisco Previously Published Works (2012)
        Traditional chemotherapy has resulted in only a modest response, if any, for the 3 most common cutaneous malignancies of basal cell carcinoma, squamous cell carcinoma, and melanoma. Recent advances in understanding of the defects in the pathways driving tumorigenesis have changed the way that we think of these cancers and paved the way to targeted therapy for specific tumors. In this review, we will introduce the novel systemic treatments currently available for these cancers in the context of what is understood about the tumor pathogenesis. We will also introduce ongoing studies that will hopefully broaden our options for highly effective and tolerable treatment.
          Cover page: Cutting edge in medical management of cutaneous oncology.
          • Article
          • Peer Reviewed
          UC San Francisco Previously Published Works (2016)
          Genital gender affirming surgery (GAS) involves reconstruction of the genitals to match a patient's identified sex. The use of hair-bearing flaps in this procedure may result in postoperative intra-vaginal and intra-urethral hair growth and associated comp
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            UC San Francisco Previously Published Works (2015)
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              UC San Francisco Previously Published Works (2013)
              Metagenomics, the study of microbial genomes within diverse environments, is a rapidly developing field. The identification of microbial sequences within a host organism enables the study of human intestinal, respiratory, and skin microbiota, and has allow
                • Article
                • Peer Reviewed
                UC San Francisco Previously Published Works (2016)
                We used RNA sequencing to study and characterize the long noncoding RNA (lncRNA) transcriptome in lesional skin from psoriasis patients before (PP) and after treatment (PT) with adalimumab and in normal skin from healthy individuals (NN). To this end, we sequenced total RNA from 18 psoriasis patients and 16 healthy controls. We merged three lncRNA reference datasets to create a single combined reference of 67,157 lncRNA transcripts with no overlaps. We identified differential expression of 971 lncRNAs between PP and NN, 157 between PP and PT, and 377 between PT and NN. Using differentially expressed lncRNAs between PP and NN, we identified a molecular lncRNA signature that distinguishes psoriatic skin from healthy skin. Furthermore, we performed an unsupervised hierarchical analysis that revealed distinct clustering of PP samples from NN. A coding noncoding network analysis revealed a large network of highly correlated lncRNA and protein coding transcripts that provided insight into the potential functions of unannotated lncRNAs. To the best of our knowledge, this description of both polyadenylated as well as nonpolyadenylated lncRNA transcripts in psoriasis has not been previously reported. Our findings highlight the potential importance of lncRNAs in the biology of psoriasis and response to treatment.
                  Cover page: Landscape of Long Noncoding RNAs in Psoriatic and Healthy Skin
                  • Article
                  • Peer Reviewed
                  UC San Francisco Previously Published Works (2016)
                    • Article
                    • Peer Reviewed
                    UC San Francisco Previously Published Works (2015)
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