Journal of Clinical Oncology, Vol 13, 1933-1938, Copyright © 1995 by American Society of Clinical Oncology

ARTICLES

Prevention of skin cancer and reduction of keratotic skin lesions during acitretin therapy in renal transplant recipients: a double- blind, placebo-controlled study

JN Bavinck, LM Tieben, FJ Van der Woude, AM Tegzess, J Hermans, J ter Schegget and BJ Vermeer
Department of Dermatology, University Hospital, Leiden, The Netherlands.

PURPOSE: The purpose of this study was to investigate the effect of acitretin on the development of keratotic skin lesions, and on squamous cell carcinomas and basal cell carcinomas in a group of renal transplant recipients. PATIENTS AND METHODS: Forty-four renal transplant recipients with more than 10 keratotic skin lesions on the hands and forearms were enrolled onto a randomized, double-blind, placebo-controlled trial to test the possible skin cancer-preventing effect of a 6-month treatment with acitretin 30 mg/d. RESULTS: No deterioration in renal function occurred in any of the 38 assessable patients treated. During the 6-month treatment period, two of 19 patients (11%) in the acitretin group reported a total of two new squamous cell carcinomas, compared with nine of 19 patients (47%) in the placebo group who developed a total of 18 new carcinomas (chi 2 = 6.27, P = .01). The relative decrease in the number of keratotic skin lesions in the acitretin group was 13.4%, as compared with a relative increase in the placebo group of 28.2% (difference, 41.6%; 95% confidence interval, 11.5 to 71.7). Most patients treated with acitretin had mild mucocutaneous side effects, but these were easily manageable. Some patients experienced mild hair loss. With the exception of three patients, no increase in serum cholesterol or triglyceride above pretreatment levels was observed, and liver function remained unchanged in all patients. CONCLUSION: Acitretin 30 mg/d over 6 months had significantly more effect than placebo in the prevention of squamous cell carcinomas and reduced the occurrence of keratotic skin lesions in a group of renal transplant recipients with severe lesions. This effect was most pronounced in patients with a history of squamous cell carcinomas and basal cell carcinomas.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				M. A. Weinstock, S. F. Bingham, R. A. Lew, R. Hall, D. Eilers, R. Kirsner, M. Naylor, J. Kalivas, G. Cole, K. Marcolivio, et al. Topical Tretinoin Therapy and All-Cause Mortality Arch Dermatol, January 1, 2009; 145(1): 18 - 24. [Abstract] [Full Text] [PDF]

				S. Y. Zafar, D. N. Howell, and J. P. Gockerman Malignancy After Solid Organ Transplantation: An Overview Oncologist, July 1, 2008; 13(7): 769 - 778. [Abstract] [Full Text] [PDF]

				F. Togel, Z. Hu, K. Weiss, J. Isaac, C. Lange, C. Westenfelder, T. Stasko, M.D. Brown, J.A. Carucci, S. Euvrard, et al. Amelioration of Acute Renal Failure by Stem Cell Therapy--Paracrine Secretion Versus Transdifferentiation into Resident Cells: Administered Mesenchymal Stem Cells Protect against Ischemic Acute Renal Failure through Differentiation-Independent Mechanisms. Am J Physiol Renal Physiol E-pub February 15, 2005 J. Am. Soc. Nephrol., May 1, 2005; 16(5): 1153 - 1163. [Full Text] [PDF]

				C. A. Harwood, M. Leedham-Green, I. M. Leigh, and C. M. Proby Low-Dose Retinoids in the Prevention of Cutaneous Squamous Cell Carcinomas in Organ Transplant Recipients: A 16-Year Retrospective Study Arch Dermatol, April 1, 2005; 141(4): 456 - 464. [Abstract] [Full Text] [PDF]

				S. Kossard, C. Thompson, and G. M. Duncan Hypertrophic Lichen Planus-Like Reactions Combined With Infundibulocystic Hyperplasia: Pathway to Neoplasia Arch Dermatol, October 1, 2004; 140(10): 1262 - 1267. [Abstract] [Full Text] [PDF]

				P. Mrass, M. Rendl, M. Mildner, F. Gruber, B. Lengauer, C. Ballaun, L. Eckhart, and E. Tschachler Retinoic Acid Increases the Expression of p53 and Proapoptotic Caspases and Sensitizes Keratinocytes to Apoptosis: A Possible Explanation for Tumor Preventive Action of Retinoids Cancer Res., September 15, 2004; 64(18): 6542 - 6548. [Abstract] [Full Text] [PDF]

				A. J. Duffield-Lillico, E. H. Slate, M. E. Reid, B. W. Turnbull, P. A. Wilkins, G. F. Combs Jr., H. K. Park, E. G. Gross, G. F. Graham, M. S. Stratton, et al. Selenium Supplementation and Secondary Prevention of Nonmelanoma Skin Cancer in a Randomized Trial J Natl Cancer Inst, October 1, 2003; 95(19): 1477 - 1481. [Abstract] [Full Text] [PDF]

				B. Dreno Skin cancers after transplantation Nephrol. Dial. Transplant., June 1, 2003; 18(6): 1052 - 1058. [Full Text] [PDF]

				S. Euvrard, J. Kanitakis, and A. Claudy Skin Cancers after Organ Transplantation N. Engl. J. Med., April 24, 2003; 348(17): 1681 - 1691. [Full Text] [PDF]

				W. A. M. Blokx, J. V. Smit, E. M .G. J. de Jong, M. M. G. M. Link, P. C. M. van de Kerkhof, and D. J. Ruiter Retinoids Strongly and Selectively Correlate With Keratin 13 and Not Keratin 19 Expression in Cutaneous Warts of Renal Transplant Recipients Arch Dermatol, January 1, 2002; 138(1): 61 - 65. [Abstract] [Full Text] [PDF]

				X.-C. Xu, W. Y. L. Wong, L. Goldberg, S. C. Baer, J. E. Wolf, W. M. Ramsdell, D. S. Alberts, S. M. Lippman, and R. Lotan Progressive Decreases in Nuclear Retinoid Receptors during Skin Squamous Carcinogenesis Cancer Res., June 1, 2001; 61(11): 4306 - 4310. [Abstract] [Full Text] [PDF]

				S. M. Lippman, J. J. Lee, D. D. Karp, E. E. Vokes, S. E. Benner, G. E. Goodman, F. R. Khuri, R. Marks, R. J. Winn, W. Fry, et al. Randomized Phase III Intergroup Trial of Isotretinoin to Prevent Second Primary Tumors in Stage I Non-Small-Cell Lung Cancer J Natl Cancer Inst, April 18, 2001; 93(8): 605 - 618. [Abstract] [Full Text] [PDF]

				S. Kossard and P. Artemi Acitretin for Hypertrophic Lichen Planus-Like Reaction in a Burn Scar Arch Dermatol, May 1, 2000; 136(5): 591 - 594. [Full Text] [PDF]

				S. M. Lippman and R. Lotan Advances in the Development of Retinoids as Chemopreventive Agents J. Nutr., February 1, 2000; 130(2): 479 - 479. [Abstract] [Full Text]