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Funding sources: This project was funded by the Australasian College of Dermatologists Scientific Research Fund. A.C. Chen was supported by an Australian Postgraduate Award and a University of Sydney Postgraduate Scholarship in Dermatology. The funders had no role in study design, data collection, data analysis, manuscript preparation and/or publication decisions.

Conflicts of interest: none declared.

Dear Editor, Immunosuppressed organ transplant recipients have an 80‐fold increased risk of squamous cell carcinoma (SCC) and a 16‐fold increased risk of basal cell carcinoma (BCC);1 SCCs are more aggressive and more likely to metastasize in these patients.2 While mammalian target of rapamycin (mTOR) inhibitors may help reduce the incidence of SCC,3 the current mainstay of nonmelanoma skin cancer (NMSC) chemoprevention post‐transplant is oral retinoids, which have side‐effects, including liver and lipid abnormalities, mucocutaneous dryness and teratogenicity.4,5

Nicotinamide (vitamin B3) enhances repair of photodamaged DNA and prevents the inhibitory effects of ultraviolet radiation on the immune system without altering baseline immune reponses.6,7,8 In 386 immunocompetent participants at high risk of having skin cancer, nicotinamide 500 mg twice daily reduced new NMSCs by 23% (P = 0·02), with 20% fewer BCCs and 30% fewer SCCs compared with placebo.9 Actinic keratoses (AKs) were also significantly reduced by nicotinamide in the same phase III randomized controlled trial.9 However, it is unknown whether nicotinamide prevents NMSCs and is safe in immunosuppressed renal transplant recipients.

Issue Section:
Correspondence > Research Letters
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