Immunosuppression Flashcards
Patients who are immunosuppressed are at increased risk for:
BCC, SCC
Factors that make patients immunosuppressed
UV Radiation, chemical exposure, HPV, medications, disease states
Pro-inflammatory mediators of the skin
serotonin, prostaglandin, interleukin 1,6,8, tumor necrosis factor alpha
Anti inflammatory mediators of the skin
depletion of langerhan cells, induction of antigen specific T cells, and release of anti inflammatory mediator interleukin 10
UV photo carcinogenesis
dna damage leads to mutation formation and then malignant malformations. Builds up a tolerance to antigens from UV induced skin tumors and cannot recognize and remove the malignant cells.
UV Radiation
UV exposure early in life = a great influence of developing skin cancers.
Odds ration association with tanning bed use of developing SCC and BCC
SCC:2.5% increase
BCC: 1.5% increase
Increased risk of SCC when exposed to these chemicals
pesticides, asphalt, tar, arsenic. occupationally with those working outdoors and pilots exposed to ionizing radiation
HPV and SCC
HPV subtypes act as co-carcinogens with UV light in development of SCC
Skin phenotype risk
red hair, freckling, fair skin, always burn and never tan increased risk of non melanoma skin cancer
Solid organ transplant patients
BCC 5-10x more likely, SCC 40-250x more likely than average
Xeroderma pigmentosum
rare skin sensitivity to sunlight = defects of DNA repair and increased risk of NMSC
Oculocutaneous albinism
increased risk d/t lack of melanocytes
Epidermodysplasia verrcuiformis
“tree man syndrome” HPV subtype = increased risk of NMSC
Dystrophic Epidermolysis Bullosa
recessive gene mutation leading to tumors and scarring ulcers = increased risk NMSC
