Figure 136

Primary basal cell carcinoma. Cutaneous carcinomas (primarily basal cell and squamous cell) comprise the greatest percentage of tumors in transplant recipients. They tend to be most problematic in fair-skinned persons whose lifestyle includes significant sun exposure; the risk increases with duration of immunosuppression. In immunocompetent patients the risks of these lesions usually are limited; however, in transplant recipients these lesions can be very aggressive and metastasize locally or even systemically. The best management is aggressive prevention: exposure to ultraviolet radiation from the sun should be minimized through diligent use of protective clothing, hats, and sunscreen. When suspicious lesions develop, early recognition and removal are of utmost importance.

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