Multiple cutaneous malignancies arising in limbs with signs of lymphatic insufficiency in transplant patients

We report the cases of four renal transplant patients who developed multipl e skin cancers located preferentially on lymphoedematous lower limbs. All s kin tumours appeared post-transplant and the diagnosis was confirmed on his tologic examination. In addition, one of the patients also under-went maste ctomy with axillary dissection and radiotherapy for a left breast ductal ca rcinoma and subsequently developed multiple squamous carcinomas and intraep ithelial carcinomas on the left upper limb. The aetiology of lymphoedema in these patients is multifactorial. In additi on to immunosuppression, ultraviolet exposure, genetic factors and possibly infection with the human papilloma virus, which are thought to have a role in the aetiology of certain skin tumours, lymphoedema may have contributed to the predominant location of these skin malignancies on the lymphoedemat ous limbs. (C) 1999 The British Association of Plastic Surgeons.