Decreased skin cancer after cessation of therapy with transplant-associated immunosuppressants

Background: Immunosuppression for solid organ transplantation is associated with increased incidence of internal and cutaneous malignant tumors, among which skin cancer is the most common. Objective: To determine the effects on cutaneous carcinogenesis when stoppi ng therapy with immunosuppressive medications. Observations: We followed the clinical course of 6 solid organ transplant r ecipients after therapy with immunosuppressant medications was stopped beca use of allograft failure or unacceptable cutaneous carcinogenesis. Generall y, we found that stopping therapy with immunosuppressive medications result ed in deceleration of cutaneous carcinogenesis, resolution of cutaneous ver rucae vulgaris, and qualitative improvements in skin condition. Four patien ts experienced marked improvement; 2 did not. Conclusions: Cessation of transplant-associated therapy with immunosuppress ive medications for patients in whom cutaneous carcinomas developed after t ransplantation may lead to deceleration of cutaneous carcinogenesis, decrea sed verrucae, and improved skin quality within 1 to 2 years. Because of the natural variation in skin cancer development and the small number of cases in this series, definitive conclusions require further study.