It is well known that solid-organ transplant recipients (SOTRs) have a 65- to 100-fold increase in the risk of developing skin cancer, namely, nonmelanoma skin cancers (NMSCs) such as cutaneous squamous cell carcinoma (cSCC) and basal cell carcinoma (BCC). In addition, these patients are also at increased risk for development of melanoma as well as other less common cutaneous malignancies (Merkel's cell carcinoma, Kaposi's sarcoma). SOTRs with NMSC (namely cSCC) are also at significantly increased risk of poor clinical outcomes including local recurrence, nodal and distant metastasis, and disease-specific death relative to patients who are not immunosuppressed. Increased surveillance and monitoring in patients at risk of aggressive disease and poor outcomes who are on immunosuppression is essential in patients with lung transplants given the high degree of immunosuppression. Increased awareness of risks, treatments, and management allows for improved outcomes in these patients. This article will provide an overview of the risk factors for the development of cutaneous malignancies in organ transplant recipients as well as a detailed discussion of various immunosuppressant and prophylactic medications used in this patient population that contribute to the risk of developing cutaneous malignancies, with an emphasis on NMSC (cSCC and BCC) in lung transplant recipients. Finally, this article includes a discussion on the clinical and dermatologic management of this high-risk immunosuppressed population including a review of topical and systemic agents for field therapy of actinic damage and chemoprevention of keratinocyte carcinomas. In addition, indications for additional treatment and preventive measures such as adjuvant radiation treatment after surgical management of cutaneous malignancies and potential modification of immunosuppressive medication regimens are discussed.

众所周知，实体器官移植受者 (SOTR) 患皮肤癌的风险增加 65 至 100 倍，即非黑色素瘤皮肤癌 (NMSC)，例如皮肤鳞状细胞癌 (cSCC) 和基底细胞癌癌（BCC）。此外，这些患者患黑色素瘤以及其他不太常见的皮肤恶性肿瘤（默克尔细胞癌、卡波西肉瘤）的风险也增加。与未免疫抑制的患者相比，具有 NMSC（即 cSCC）的 SOTR 也显着增加不良临床结果的风险，包括局部复发、淋巴结和远处转移以及疾病特异性死亡。鉴于高度免疫抑制，对有侵袭性疾病风险和免疫抑制不良预后的患者加强监测和监测对于肺移植患者至关重要。提高对风险、治疗和管理的认识可以改善这些患者的预后。本文将概述器官移植受者发生皮肤恶性肿瘤的风险因素，并详细讨论该患者人群中使用的各种免疫抑制剂和预防性药物，这些药物会导致发生皮肤恶性肿瘤的风险，重点是在肺移植受者的 NMSC (cSCC 和 BCC) 上。最后，本文讨论了这一高危免疫抑制人群的临床和皮肤病学管理，包括对光化性损伤现场治疗和角质形成细胞癌化学预防的局部和全身性药物的回顾。此外，还讨论了额外治疗和预防措施的适应症，例如皮肤恶性肿瘤手术治疗后的辅助放射治疗和免疫抑制药物治疗方案的潜在修改。