Date of Award

1-1-2023

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Sean R. Christensen

Abstract

Cutaneous squamous cell carcinoma (cSCC) is a significant cause of death and morbidity and effective prevention strategies are needed. Acitretin has been shown to decrease the incidence of cSCC in immunosuppressed solid organ transplant recipients (SOTR) at high risk of subsequent cSCC, but data on effectiveness in other populations are limited, and discontinuation of acitretin has been reported to cause a rebound increase in cSCC. Our objective was to assess the effectiveness of acitretin for cSCC and skin cancer prevention in immunocompetent and immunosuppressed populations. A retrospective cohort study was performed at a single academic institution. Patients with a history of at least 2 cSCC treated with acitretin for skin cancer prevention from 2012-2018 were identified by electronic medical record review. Demographic information, skin cancer history, treatment details, laboratory data, and reported adverse effects were collected. Primary outcomes were the rate and type of skin cancer development before, during, and after acitretin therapy. The primary cohort for skin cancer prevention with acitretin consisted of 34 patients. 9 patients were immunosuppressed SOTR, 5 patients were immunosuppressed due to other causes, and 20 patients were immunocompetent. There was a 68% decrease in the rate of invasive cSCC during acitretin therapy (p

Comments

This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.

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