Date of Award
Open Access Thesis
Medical Doctor (MD)
Oscar R. Colegio
SKIN CANCER OUTCOMES AS A FUNCTION OF REFERRAL REASON IN SOLID ORGAN TRANSPLANT RECIPIENTS. Sakil Chundydyal, Fang-Yong Li, Oscar R. Colegio, Department of Dermatology, Yale School of Medicine, New Haven, CT.
Purpose of study: The purpose of this study is to examine the reason for referral of Organ Transplant Recipients (OTR) to a specialized dermatology clinic as a predictor of Non Melanoma Skin Cancer outcomes in those patients.
Methods: A retrospective chart study was conducted using the records for current OTR patients referred to a specialized transplant dermatology clinic from 1991 to 2012. The data reasons for referral as well as outcomes in terms of diagnosis of premalignant/malignant cutaneous lesions.
Results: 353 patient records were recorded. 81 patients were diagnosed with a total of 491 premalignant/malignant skin lesions. The reason for referral most closely associated with lesion diagnosis was “lesion of concern/skin cancer”, with 26% of these patients being diagnosed within 6 months, and 50% of them diagnosed over follow-up. 37% of the patients referred for “rash/acne” were diagnosed with BCC within 6 months of referral. 17.8% of patients who are referred for “acne/rash” eventually get diagnosed with malignant/premalignant lesions.
Conclusions: This is the first study to examine the link between the reason for referral of OTR to specialized dermatologic care and patient outcomes. Our results show that despite the well-established increased risk of OTR for skin malignancies, there are still significant delays in timely referrals and eventual diagnoses. A more efficient risk-stratification and referral process will likely lead to better patient outcomes and a decreased tumor burden for these patients.
Chundydyal, Sakil, "Skin Cancer Outcomes As A Function Of Referral Reason In Solid Organ Transplant Recipients" (2015). Yale Medicine Thesis Digital Library. 1957.