Date of Award

January 2015

Document Type

Open Access 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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This is an Open Access Thesis.

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