International Transplant Skin Cancer Collaborative

A successful weekend in San Diego! A big thank you to Dr. Lee Wheless who took the lead in planning such a wonderful ITSCC annual meeting at the Lane with phenomenal speakers!

The ITSCC Annual Meeting featured: Dr. James Rice on immunosuppression regimens, Dr. Richard Wang on HPV biology and treatments for recalcitrant warts, Dr. Soo Park on systemic cancer treatments in immunosuppression, and Dr. Robert Novoa on AI in skin cancer research.

Dr. Nathalie Zeitouni, Dr. Sean Christensen, Dr. Carrie Coughlin, Dr. Basia Michalski-McNeely, Dr. Kelsey Hirotsu, Dr. Lauren Crow, Dr. Kristin Bibee, Dr. Joi Carter presented on skin disease in transplant recipients and immunosuppressed patients at AAD!

Congratulations to outgoing president Dr. Justin Leitenberger and incoming president Dr. Anokhi Jambusaria!

Outstanding ITSCC symposium tonight in San Diego. Congratulations to outgoing President Dr. Justin Leitenberger and incoming President Dr. Anokhi Jambusaria.

Please join us for our in-person annual meeting in San Diego on March 7 from 5:30-10 p.m at The Lane in association with the AAD annual meeting!

Apply to be a mentor or a mentee for the ITSCC Academic Mentorship program (IAMP)!

IAMP is designed to connect junior members of ITSCC early in their academic careers with established, senior members to build relationships and assist in career development.
For more information on this program, visit itscc.org

Application Link: https://www.itscc.org/about-itscc/news-and-events

Application Deadline: January 5th 2024

Dr. Lauren Crow on her experience as an IAMP mentee:

As someone who has based my career path on the awesome examples set by my many ITSCC mentors, I was ecstatic to be chosen to participate in the leadership program. It has been very fun and informative to meet with our small group to hear the quarterly talks and discussions, and to bounce ideas off so many great research minds. I am excited to work with my mentor, Dr Nathalie Zeitouni, on a review article and to talk alongside her in a transplant Derm forum at the upcoming AAD. These opportunities gained through the IAMP program are laying the foundation for a career giving back to patients and colleagues through collaborative research.

Mohs Surgery or Micrographic Surgery is a procedure performed by board-certified dermatologists with additional training in dermatologic surgery. If diagnosed with skin cancer, you may be referred to a Mohs Surgeon for treatment. A Mohs surgery aims to remove all of the skin cancer while protecting the healthy skin around it. The skin cancer is removed and checked under the microscope right away while the patient is still in the office. Once all of the cancer has been removed, the wound is closed. Mohs Surgery reduces the need for other treatments or more surgery.

Sun Safety is necessary all year round. Harmful UV rays can reach your skin even on a gloomy, cloudy day. It’s important to protect your skin and follow sun-safety guidelines throughout the year, not just during the summer.

What is an Actinic Keratosis? An AK is a pre-cancerous skin lesion that can develop into Squamous Cell Carcinoma (SCC). It appears as a rough scaly patch on the skin. 58 million Americans have one or more AKs.

Follow our sun safety tips and protect your skin from sun damage early!

What are the warning signs of Squamous Cell Carcinoma (SCC) on the skin?

The American Association of Dermatology (AAD) lists the following as things to watch out for!

SCC on the skin can appear as:

A rough reddish scaly area
An open sore
A brown spot that looks like an age spot
A firm, dome-shaped growth
A wart-like growth
A horn-shaped lesion growing on the skin
A sore developing from an old scar

SCC can also appear:
Inside the mouth as a sore or smooth red/white patch
In the ge****ls or the a**s as a raised red area or a wart-like sore
In the nails as a wart-like sore or a red, brown, or black line beneath a nail

Squamous Cell Carcinoma (SCC) is most common on the sun-exposed skin such as the face, the lips, the bald scalp or the hands.

Organ Transplant recipients are more likely than the general population to develop skin cancer. It is critical to protect your skin from sun damage to prevent the development of skin cancers!

Sunscreen is your best friend!

ITSCC and Transplant Families are collaborating to raise awareness on the importance of dermatological care for pediatric transplant patients! Transplant patients are at a higher risk for skin cancer, skin infection, and cosmetic issues like acne and as such, sun safety and frequent skin examinations should be a part of their medical care.

Transplant Families' mission is to unite families who have children with solid organ or bone marrow transplants by providing inspiration, support, and education. We aim to help patients and families make the most of life before, during, and after transplant.

The International immunosuppression & Transplant Skin Cancer Collaborative (ITSCC) is an organization of physicians, surgeons and scientists from multiple disciplines dedicated to advancing the care and understanding of skin cancer in organ transplant recipients and other immunosuppressed patients. We aim to educate patients, researchers, and care teams on the dermatological care unique to transplant recipients and other immunosuppressed patients.

Four years of experience helping transplant teams triage referrals for skin cancer screening!

Transplant recipients are susceptible to infections due to their immunosuppressive medications. These include bacterial, viral and fungal skin infections.

Among bacterial skin infections, Staphylococcus and Streptococcus are often the main culprits.

Viral infections are most commonly caused by the Human Papillomavirus (HPV), Herpes Virus and Molluscum. HPV is responsible for warts. There are several Herpes Viruses and these may cause cold sores or ge***al herpes, shingles, and infectious mononucleosis or “mono”. Molluscum Contagiosum causes flesh-colored or pink dome-shaped bumps on the skin.

Fungal infections include Tinea Versicolor, Onychomycosis, Tinea Pedis and Tinea Cruris. In Tinea Versicolor, overgrowth of fungus on the skin can result in uneven skin color or scaling and may be itchy. Onychomycosis is a fungal infection of the nails, often the toenails. Tinea Pedis is a fungal infection of the feet that causes itchiness and redness in the soles of the feet and the spaces between the toes. Finally, Tinea cruris is a fungal infection of the groin where the skin becomes itchy, red and scaly.

For more information on skin infections affecting transplant recipients, visit our website at itscc.org

Hair Loss may occur temporarily and last up to one year after transplant surgery. This is generally transient and full re-growth of the hair is expected to occur. No treatment is required for this.

Acne is common among transplant recipients and is caused by corticosteroids taken as part of the post-transplant medication regimen.

Immunosuppression may also lead to bacterial overgrowth in the skin and this can lead to folliculitis in transplant recipients.

Dry skin is also common in transplant recipients and can be worse in the winter months.

For more information on dermatological issues affecting transplant recipients, visit our website at itscc.org

Board Member Highlight: Vice-President Dr. Anokhi Jambusaria-Pahlajani!

Dr. Anokhi Jambusaria is an associate professor in the Department of Internal Medicine, Division of Dermatology at Dell Medical School in Austin, TX. She earned her medical degree from the Temple University School of Medicine and completed both her dermatology residency and master’s degree in epidemiology from the University of Pennsylvania School of Medicine. Upon her graduation, she worked at Mayo Clinic Jacksonville, specializing in transplant dermatology and high-risk skin cancer, before relocating to Texas in 2015.
As an epidemiologist, Dr. Jambusaria has a strong research interest in high-risk skin cancer and transplant dermatology. Early in her career, she was the recipient of the prestigious Dermatology Foundation Career Development Award in Public Policy. The results of her research in squamous cell carcinoma outcomes were incorporated in the 8th edition American Joint Committee on Cancer staging for cutaneous SCC. Dr. Jambusaria’s research interests also include defining and optimizing care for patients with field cancerization and skin cancer prevention, particularly in the immunosuppressed population. She serves as Vice-President of the International Transplant Skin Cancer Collaborative (ITSCC) and actively participates in clinical trials on high-risk nonmelanoma skin cancer and skin cancer prevention.

Favorite ITSCC symposium memory

I have SO many, but if you made me pick it would be when I dressed up as my mentor for the ITSCC retreat Halloween Party!

Highlights of your involvement with ITSCC

When I was a junior faculty, one of my mentors Chrys Schmults volunTOLD me that I would be presenting at the upcoming ITSCC retreat. At the time, I knew very little about ITSCC, other than it was a group of people who were interested in transplant dermatology. I had no idea what would be in store for me—glamping with what would become my “derm besties” and a weekend filled with incredible science and improving the care of transplant patients! From that weekend on, I was hooked. I made sure to go to national meetings so that I could attend ITSCC events. Between 2015-2018, I had the honor of serving on the Board of Directors. Since 2022, I have been Vice-President and will take over the role of President in 2024. Being involved with ITSCC has given me purpose and focus in my career, ensuring that we are always striving to provide the best care for transplant patients, and I have been honored to be part of the growth of this incredible organization.

What are the three most common skin cancers? Squamous Cell Carcinoma (SCC); Basal Cell Carcinoma (BCC) and Melanoma. Here are some common features, statistics and pictures!

Talk to your dermatologist if you see a suspicious spot on your skin!

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Choosing a sunscreen can be overwhelming! What are the important features you should look for when buying sunscreen?

SPF 30 or above
Water resistant sunscreens
Broad spectrum coverage

Don’t forget to apply and reapply!

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Skin biopsy wounds can be uncomfortable or painful. These tips from the American Academy of Dermatology (AAD) can help you navigate how to care for a skin biopsy wound from home!

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Most of us have experienced being sunburned and it is generally not pleasant! These wonderful tips from the American Academy of Dermatology (AAD) can help you care for a sunburn from home!

Don’t forget your SPF!

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Summer is here! Protecting your skin from sun damage is crucial to preventing skin cancer and premature aging. Follow these helpful tips to keep your skin sun safe throughout the summer!

Don’t forget your SPF!

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We are : The International Immunosuppression & Transplant Skin Cancer Collaborative. Learn more about us on our website at itscc.org.

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What is a transplant dermatologist?

Immunosuppression renders many transplant patients more susceptible to several skin conditions. These conditions include several types of skin cancers, skin infections, dry skin, and acne. Immunosuppressed patients may require different management and as such, transplant dermatologists are specifically trained to provide tailored care for these patients.

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We often miss these spots when applying SPF!

The neck, the sides of the face, the ears, the lips, the eyelids, the hairline, the back of the hands and top of the feet.

Don’t forget your SPF!

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May is Skin Cancer Awareness Month! 1 in 5 Americans will develop skin cancer by the age of 70. Summer is coming up and sun safety is critical to shielding your skin from harmful sun rays. Avoid sunburns by practicing sun safety. SPF if your best friend!

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Skin cancer is highly curable when caught or treated early. Self-skin checks are quick and easy and can help you catch suspicious spots on your skin that may be cancerous! Here are some helpful tips on how to perform one at home on your own using a mirror!

Opinion | My Transplanted Heart and I Will Die Soon Organ transplantation is mired in stagnant science and antiquated, imprecise medicine that fails patients and organ donors.

Our ITSCC Annual Meeting in association with the AAD brought together trainees, clinicians, scientists and other professionals from all over the world! Over the weekend, attendees explored Mardi Gras World while learning about clinical scenarios, had opportunities to present their research and network with the transplant dermatology community. The agenda featured our Oscar Colegio Memorial Lecturer, Dr. Clark Otley, as well as presentations from our expert members describing, “How we do it” for challenging clinical scenarios frequently encountered in our immunosuppressed patients.

Outstanding ITSCC scientific meeting last night. If you missed it, keep an eye on the listserv for a summary. Not a member yet? Or have you missed your membership dues this year? Visit www.itscc.org to join or check on your membership status.

Clark Otley gives the Oscar Colegio Memorial Lecture at the ITSCC annual meeting.

What does it mean to be immunosuppressed or immunocompromised?

Being immunosuppressed or immunocompromised means having a weak immune system.

How do I know if I am immunosuppressed?

Individuals who are immunosuppressed generally may: 1) take a medication that weakens their immune system, 2) carry an inherited genetic mutation that affects the proper functioning of their immune system, or 3) have a condition that suppresses their immune system like human immunodeficiency virus (HIV). If you are unsure whether you are immunosuppressed, ask your doctor.

After an organ transplant, patients are placed on immunosuppressive medication that weakens their immune system to prevent organ rejection. This immune suppression predisposes patients to several types of skin cancers.

Why is this relevant to skin cancer?

Our immune system is constantly fighting damage from harmful sun rays on our skin. When our immune system is not working well, skin cancers are more likely to occur. Therefore, a weak immune system from illness or medications that suppress your immune system can increase your risk of developing skin cancer. In fact, transplant recipients have 65 to 100 times the risk of developing squamous cell cancer (SCC) of the skin and 10 times the risk of developing basal cell cancer (BCC) of the skin versus someone who has not had a transplant. However, if caught early, the large majority of SCCs and BCCs are curable.

How can I protect myself from the sun if I am immunosuppressed?

Whether or not you are immunosuppressed, sun safety is always important! It reduces your risk of developing skin cancer and reduces sun damage to the skin. One of the most important aspects of sun safety is using sunscreen SPF 30 or above throughout the year. Check out our sun safety post for more information on how to best protect your skin against sun damage!