Resurfacing the back of the hand as treatment and prevention of multiple skin cancers in kidney transplant recipients

Background: Skin cancer is a serious problem in renal transplant recipients. In some patients numerous skin cancers develop on the back of the hand. Instead of repeated excisions, a more radical procedure may be necessary. For these patients a new surgical therapy is available: resurfacing the back of the hand. Objective: Our purpose was to clinically evaluate this new procedure. Methods: Eleven kidney transplant recipients who underwent resurfacing of the back of the hand were analyzed in a retrospective follow-up study. With this surgical procedure the skin of the entire dorsum of the hand is excised and split-skin grafts harvested from thigh and buttock skin are then placed. Information was gathered from the medical records and questionnaires, and by physical examination. Results: The mean follow-up time was 4.7 years. No recurrences of skin cancer were observed in the transplanted skin. The cosmetic appearance was acceptable, and there were few side effects. Conclusion: Resurfacing the back of the hand can be a successful treatment for carefully selected patients with multiple skin cancers on the back of the hand and can be used prophy-lactically in patients with severely actinically damaged skin.