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Immunosuppression refers to the weakening of the body's immune system, which can result from primary inherited disorders or secondary causes, such as diseases or medications. Common causes include lymphoproliferative disorders, HIV/AIDS, and the use of immunosuppressive therapies for conditions such as autoimmune diseases and after organ transplantation. Regardless of its origin, a compromised immune system increases the risk of malignancies compared to the general population.[1] Under normal conditions, the immune system continually monitors and eliminates potentially cancerous cells. However, this surveillance is impaired in patients with immunosuppression, allowing abnormal cells to proliferate unchecked. Therefore, in immunosuppressed populations, nonmelanoma skin cancers—particularly squamous cell carcinoma (SCC) and basal cell carcinoma (BCC)—are more common and also tend to demonstrate more aggressive behavior, including higher rates of metastasis and recurrence. Although BCC predominates in immunocompetent individuals, SCC is more prevalent in immunosuppressed populations.[1][2][3] Additionally, skin cancers in immunosuppressed patients tend to exhibit increased aggressiveness, recurrence, and metastatic potential.[4][5][6][7] Therefore, treating skin cancers in this demographic requires careful consideration and often an integrated, interdisciplinary approach. The following section explores further strategies for managing skin cancer in patients with immunosuppression.

A multidisciplinary approach is essential to effectively prevent and manage skin cancer in immunosuppressed patients. This strategy involves the collaboration of a diverse team of healthcare professionals, including primary care providers, dermatologists, oncologists, transplant specialists, and other subspecialists who are involved in managing the underlying conditions that necessitate immunosuppression. Dermatologists play a critical role in conducting regular skin examinations and in the early detection and treatment of precancerous lesions. Oncologists may be required to guide the treatment of more advanced cases. For patients with organ transplants, transplant specialists contribute by balancing immunosuppressive regimens to reduce cancer risk while ensuring transplant viability. Coordination among healthcare providers is essential for a holistic approach that addresses both the patient’s cancer risk and underlying health needs. Frequent communication and shared decision-making enable timely adjustments to treatment plans, reducing the risk of early progression and effectively managing tumor burden. Additionally, a collaborative approach allows for personalized, proactive care strategies that can significantly enhance patient outcomes and quality of life. A comprehensive, collaborative team-based approach is essential for optimizing the management of skin cancer risk in immunosuppressed patients. This strategy aims to prevent complications and provide the highest level of care for this vulnerable population.