Date of Award

January 2015

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Oscar R. Colegio

Subject Area(s)

Medicine, Oncology

Abstract

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.

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