PDF icon Download PDF
Open Access
CC-BY-NC-ND 4.0 · J Reconstr Microsurg Open 2017; 02(01): e42-e45
DOI: 10.1055/s-0037-1602254
Letter to the Editor: Short Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Staged Excision of Squamous Cell Carcinoma and Actinic Keratosis of the Scalp with Staged Free Flap Inset in a Posttransplant Patient

Rachel Pedreira
1   Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland
,
Brian H. Cho
1   Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland
,
Arthur Nam
2   Division of Trauma Plastic Surgery, R Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, Maryland
,
Paul N. Manson
1   Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland
2   Division of Trauma Plastic Surgery, R Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, Maryland
,
Angela Geer
1   Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland
,
Michael Grant
2   Division of Trauma Plastic Surgery, R Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, Maryland
,
Justin M. Sacks
1   Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland
,
Ramon A. DeJesus
1   Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland
2   Division of Trauma Plastic Surgery, R Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, Maryland
3   Division of Plastic and Reconstructive Surgery, National Military Center San Diego, San Diego, California
› Author Affiliations
Further Information

Publication History

31 January 2017

06 March 2017

Publication Date:
21 April 2017 (online)

Also available ateRefMedOne
  Permissions and Reprints
Preview

Immunosuppressive drugs are vital after solid-organ transplantation for rejection prevention but are also associated with significant complications. Malignancy as a product of immunosuppression is a common cause of posttransplant morbidity and mortality. The most common cancer in transplant patients is squamous cell carcinoma of the skin (SCCS).[1] Given the rising incidence of posttransplant malignancy due to advances in perioperative care extending life expectancies, methods for addressing posttransplant SCCS merit investigation.

The scalp is one area at risk for SCCS in posttransplant patients. Scalp SCCS has a propensity for being particularly aggressive, thereby necessitating equally aggressive resection to prevent progression, metastasis, and recurrence.[2] The resulting scalp defect after resection is often large and challenging to reconstruct. Rotational scalp flaps and skin grafts are effective treatment modalities; however, larger defects often require free tissue transfer for adequate soft tissue coverage. We present a unique case of recurrent SCCS of the scalp and describe a novel surgical approach.