184 Marked racial differences in post-transplant diseases

Importance: Skin cancer risk has been well-characterized in White organ transplant recipients (OTRs); however, the majority of patients on the waitlist for organs in the United States are nonwhite individuals. Little is known about skin cancer risk in this population. Objective: To compare cutaneous disease between White and nonwhite OTR. Design: Retrospective chart review of 154 White and 258 nonwhite OTR seen between 11/1/2011 and 4/22/16. Outcomes: Demographics, frequency and type of cancer, anatomical location, time-course, sun exposure, risk awareness, and preventative behavior. Results: White OTRs more commonly presented with malignancy at their first visit, whereas nonwhite OTRs presented more commonly with infectious and inflammatory conditions. The prevalence of skin cancer was 41.6% and 5.8% in White and nonwhite OTRs, respectively. The majority of lesions in White and Asian OTRs, 79.5% (N=294) and 83.3% (N= 5), occurred in sun-exposed areas. In the Black population, 66.7% (N= 6) of lesions occurred in sun-protected areas, specifically the genitals. Fewer nonwhite than White OTR reported having regular dermatologic examinations and knowing the signs of skin cancer. Conclusions: Early management of nonwhite OTRs should focus on inflammatory and infectious disease. Sun protection should continue to be emphasized in White, Asian, and Hispanic OTR. Black OTR should be counseled to recognize the signs of genital HPV infection. Optimal post-transplant dermatologic care may be determined based on the race/ethnicity of the patients, yet a baseline full skin assessment should be performed in all patients. All nonwhite OTR should be counseled more effectively on the signs of skin cancer, with focused discussion contingent on skin type and race/ethnicity.