Melanoma in a cohort of organ transplant recipients: Experience from a dedicated transplant dermatology clinic in Victoria

Background: The incidence of melanoma is increased and prognosis is poorer in organ transplant recipients (OTRs).
Objective: We described the incidence and characteristics of melanoma in a cohort of OTRs attending a specialised transplant dermatology clinic. We also determined how many benign pigmented naevi were biopsied to diagnose one melanoma.
Methods: We performed a retrospective study of a dedicated specialised OTR clinic in Victoria over a 10-year period. Histologically verified melanomas in this cohort were described. We also calculated the ratio of melanoma vs. pigmented naevi excised.
Results: 327 OTRs were included in the study. A total of 12 melanomas were diagnosed in 10 patients (one patient had three primary melanomas). The mean interval between first transplant and diagnosis of melanoma was 5.5 years. Seven invasive and five in-situ melanomas were found, during a total follow up of 1280.2 patient-years. All apart from two were <1mm in Breslow thickness. Eight of the melanomas were de novo (66%). A contiguous naevus was present in four cases. The mean duration of immunosuppression was 13.9 years (± 8.7), the mean duration of follow up for the entire cohort was 3.9 years (± 3.4 years). The mean duration of follow up for the melanoma patients from the time of diagnosis was 7.5 years. All our patients remained alive and recurrence free. For every 1 melanoma diagnosed, 13.8-pigmented naevi were biopsied.
Conclusion: OTR patients attending a specialised OTR dermatology service seemed to have a better outcome, possibly because melanomas were detected early. This is also the first time a benign: malignant ratio for pigmented lesions has been described for OTRs.

Dr. Danit Maor

Skin & Cancer Foundation Inc., Victoria, Australia

Dr Danit Maor completed a Bachelor of Medicine and a Bachelor of Surgery (MBBS) at the University of Western Australia. She is currently the Occupational Dermatology Research fellow at the Skin & Cancer Foundation, Inc. in Victoria.
Last year she was the Research and Education Fellow at the Skin & Cancer Foundation focussing on transplant dermatology, research and educational workshops on a variety of different dermatological skills and topics.
Danit is due to complete a Masters of Public Health and Tropical Medicine in December this year.