Solid organ transplant recipients presenting for mohs micrographic surgery: A retrospective case-control study

Background: Solid organ transplant recipients (SOTR) have a high risk of cutaneous malignancy. Mohs micrographic surgery (MMS) is recommended for the treatment of skin cancers in this group. The characteristics of the tumors in SOTR presenting for MMS are not well documented. Objective: To describe the characteristics of tumors in SOTR presenting to a single institution over an 11-year period and compare them with tumors of non-SOTR who have also undergone MMS. Methods: A database query captured patients with a current organ transplant who underwent MMS. These patients (cases) were matched to controls who also underwent MMS. Statistical models were used to identify tumor and operative characteristics significantly associated with SOTR compared with matching controls. Results: Ninety-two SOTR underwent MMS for 432 skin cancers; 163 controls had 269 skin cancers. Squamous cell carcinoma (SCC) was the most common tumor in SOTR, with a reversal of the usual ratio of basal cell carcinoma to SCC. Mean tumor and defect sizes were similar in SOTR and controls. Cardiac transplants were the predominant transplant. Conclusions: SOTR referred for MMS have disproportionately more and different types of skin cancers than controls.