Destructive management of skin cancers in organ transplant recipients.

摘要

Destructive therapies, namely cryotherapy and curettage and electrodessication (C&ED), play an important role in the day-to-day management of skin malignancies and premalignant lesions in the organ transplant recipient (OTR). When compared with other modalities such as surgical excision, topical immunomod-ulatory agents, or radiotherapy, destructive therapies are simple, inexpensive, and quick procedures that are readily carried out in the clinician's office. Destructive therapies are particularly useful when dealing with large numbers of lesions, which in the OTR can arise within a relative short period of time and for which other therapies may become impractical. Destructive therapies also provide an alternative when surgery is not suitable, for example, in patients with concurrent medical conditions such as pacemakers or coagulopathies, at body sites at which scar contractures may be a problem (e.g., digits), for patients who refuse to have surgery, or those with incurable tumours where treatment is aimed at palliation only.