2340 Sutter Street, N431
San Francisco, CA 94115
Sarah T. Arron, MD, PhD
Ernesto Llamado, Lab Manager
(415) 514-9769 (Office)
(415) 476-8733 (Fax)
OTR Cohort Study
Sarah T. Arron, MD, PhD [ Full Biosketch ]
Dr. Sarah Arron, a dermatologic surgeon, is director of the High Risk Skin Cancer Program, which cares for patients who are at risk for skin cancer due to organ transplant, leukemia, lymphoma or genetic syndromes. She specializes in an advanced procedure called Mohs micrographic surgery to treat certain types of skin cancer. Arron also is an expert in facial reconstruction following surgery, laser surgery, dermatology for organ transplant recipients and for those with genetic risk factors for skin cancer. In addition, she performs cosmetic procedures including Botox and soft tissue fillers.
Arron's research interests include studying skin cancer, particularly in patients who are immunosuppressed. She earned a medical degree at Weill Medical College of Cornell University and a doctorate at The Rockefeller University. She completed a residency in dermatology and a fellowship in Mohs micrographic surgery and procedural dermatology at UCSF. Arron is an assistant professor in residence of dermatology at UCSF and the Helen Diller Family Comprehensive Cancer Center.
The Arron laboratory investigates the genomics and metagenomics of cutaneous squamous cell carcinoma in organ transplant recipients.
Squamous cell carcinoma (SCC) is the second most common type of skin cancer, with an estimated incidence of over 200,000 cases per year in the United States and a 65-fold increased risk in immunosuppressed organ transplant recipients over the general population. This magnitude of risk implies a viral etiology, but no viral agent has been definitively identified. Another hypothesis is that failure of immune surveillance predisposes transplant recipients to SCC. These hypotheses are not mutually exclusive; immunosuppression can predispose to viral infection and to skin cancer.
A primary research question for our group is whether there is a viral etiologic agent in SCC in immunosuppressed patients and in the general population. Human papillomavirus (HPV) has been implicated in SCC formation, but the mechanism is unclear. HPV DNA in the skin correlates with age and immunosuppression, but viral transcription is not detected in cutaneous SCC. This implies that a viral agent must use an alternate mechanism of oncogenesis.
Tumorigenesis may occur in the absence of viral infection. Oncogenesis appears to be triggered by TP53 mutation, followed by loss of heterozygosity and accumulation of various passenger mutations. Biallelic mutations also occur in Notch.
Risk factors for SCC following organ transplantation include older age at transplant, fair skin, and male sex. Certain medications appear to increase this risk as well. We seek to address the interaction between genetic risk factors and exogenous agents in our clinical cohort, OTR2.
Selected Peer Reviewed Publications
- Fitzpatrick skin phototype is an independent predictor of squamous cell carcinoma risk after solid organ transplantation. Gogia R, Binstock M, Hirose R, Boscardin WJ, Chren MM, Arron ST. J Am Acad Dermatol. 2012 Oct 26. doi:pii: S0190-9622(12)01035-3. 10.1016/j.jaad.2012.09.030.
- Cutaneous Squamous Cell Carcinoma and Human Papillomavirus: Is There an Association? Aldabagh B, Angeles JG, Cardones AR, Arron ST. Dermatol Surg. 2012 Aug 28. doi: 10.1111/j.1524-4725.2012.02558.x.
- Factors Affecting Sunscreen Use and Sun Avoidance in a U.S. National Sample of Organ Transplant Recipients. Mihalis E, Wysong A, Boscardin WJ, Tang JY, Chren MM, Arron ST. Br J Dermatol. 2012 Aug 9. doi: 10.1111/j.1365-2133.2012.11213.x.
- Efficacy and safety of vismodegib in advanced basal-cell carcinoma. Sekulic A, Migden MR, Oro AE, Dirix L, Lewis KD, Hainsworth JD, Solomon JA, Yoo S, Arron ST, Friedlander PA, Marmur E, Rudin CM, Chang AL, Low JA, Mackey HM, Yauch RL, Graham RA, Reddy JC, Hauschild A. N Engl J Med. 2012 Jun 7;366(23):2171-9.
- Cutting edge in medical management of cutaneous oncology. Chong K, Daud A, Ortiz-Urda S, Arron ST; UCSF High Risk Skin Cancer Program. Semin Cutan Med Surg. 2012 Jun;31(2):140-9.
- High cumulative dose exposure to voriconazole is associated with cutaneous squamous cell carcinoma in lung transplant recipients. Singer JP, Boker A, Metchnikoff C, Binstock M, Boettger R, Golden JA, Glidden DV, Arron ST. J Heart Lung Transplant. 2012 Jul;31(7):694-9. Epub 2012 Apr 6.
- Validity of patient skin cancer report among organ transplant recipients. Dybbro E, Mihalis E, Hirose R, Arron ST. Clin Transplant. 2012 Mar-Apr;26(2):E132-6. doi: 10.1111/j.1399-0012.2012.01601.x. Epub 2012 Mar 20.
- The 7th edition AJCC staging system for cutaneous squamous cell carcinoma accurately predicts risk of recurrence for heart and lung transplant recipients. Metchnikoff C, Mully T, Singer JP, Golden JA, Arron ST. J Am Acad Dermatol. 2012 Nov;67(5):829-35. doi: 10.1016/j.jaad.2012.01.010. Epub 2012 Jan 29.
- Therapeutic Approaches to Basal Cell Carcinoma. Mokaya K, Yom SS, Arron ST. Practical Dermatology 2011, Nov (Supp).
- Loss-of-function mutations in Notch receptors in cutaneous and lung squamous cell carcinoma. Wang NJ, Sanborn Z, Arnett KL, Bayston LJ, Liao W, Proby CM, Leigh IM, Collisson EA, Gordon PB, Jakkula L, Pennypacker S, Zou Y, Sharma M, North JP, Vemula SS, Mauro TM, Neuhaus IM, Leboit PE, Hur JS, Park K, Huh N, Kwok PY, Arron ST, Massion PP, Bale AE, Haussler D, Cleaver JE, Gray JW, Spellman PT, South AP, Aster JC, Blacklow SC, Cho RJ. Proc Natl Acad Sci U S A. 2011 Oct 25;108(43):17761-6.
- Temporal Dissection of Tumorigenesis in Primary Cancers. Durinck S, Ho C, Wang NJ, Liao W, Jakkula LR, Collisson EA, Pons J, Chan SW, Lam ET, Chu C, Park K, Hong SW, Hur JS, Huh N, Neuhaus IM, Yu SS, Grekin RT, Mauro TM, Cleaver JE, Kwok PY, Leboit PE, Getz G, Cibulskis K, Aster JC, Huang H, Purdom E, Li J, Bolund L, Arron ST, Gray JW, Spellman PT, Cho RJ. Cancer Discov. 2011 Jul 1;1(2):137-143.
- Viral oncogenesis and its role in nonmelanoma skin cancer. Arron ST, Jennings L, Nindl I, Rosl F, Bouwes Bavinck JN, Seçkin D, Trakatelli M, Murphy GM; Viral Working Group of the International Transplant Skin Cancer Collaborative (ITSCC) & Skin Care in Organ Transplant Patients, Europe (SCOPE). Br J Dermatol. 2011 Jun;164(6):1201-13.
- Validation of a diagnostic microarray for human papillomavirus: coverage of 102 genotypes. Arron ST, Skewes-Cox P, Do PH, Dybbro E, Da Costa M, Palefsky JM, Derisi JL. J Nucleic Acids. 2011;2011:756905.
- Transcriptome Sequencing Demonstrates that Human Papillomavirus Is Not Active in Cutaneous Squamous Cell Carcinoma. Arron ST, Ruby JG, Dybbro E, Ganem D, Derisi JL. J Invest Dermatol. 2011 Aug;131(8):1745-53.
- Catastrophic squamous cell carcinoma in lung transplant patients treated with voriconazole. Ibrahim SF, Singer JP, Arron ST. Dermatol Surg. 2010 Nov;36(11):1752-5.
- Cancer-Associated Fibroblasts Are Activated in Incipient Neoplasia to Orchestrate Tumor-Promoting Inflammation in an NF-kappaB-Dependent Manner. Erez N, Truitt M, Olson P, Arron ST, Hanahan D. Cancer Cell. 2010 Feb 17;17(2):135-47.
- Chronic phototoxicity and aggressive squamous cell carcinoma of the skin in children and adults during treatment with voriconazole. Cowen EW, Nguyen JC, Miller DD, McShane D, Arron ST, Prose NS, Turner ML, Fox LP. J Am Acad Dermatol. 2010 Jan;62(1):31-7.
Sarah Arron, Principal Investigator
Lionel Brooks III, PhD, Postdoctoral Scholar
Lionel performs functional genetic studies utilizing a 3-D culture model of the interfollicular epidermis. He received his PhD in genetics from Dartmouth's Geisel School of Medicine.
Darwin Chang, Undergraduate student, UCSB
Darwin works on DNA damage repair in cutaneous squamous cell carcinoma.
Kevin Lai, Bioinformatics Analyst
Kevin investigates the genomics of cutaneous squamous cell carcinoma and dermal sarcoma. He received his Master’s in Bioinformatics from San Jose State University.
Ernesto Llamado, Lab Operations
Ernesto coordinates the administrative functions of the laboratory.
Stefan Lowenstein, Medical student, UCSF
Stefan works on the epidemiology of skin cancer after solid organ transplantation.
Niko Pascua, Medical student, UCSF
Niko works on performance measures in Mohs micrographic surgery and health outcomes associated with HIV lipodystrophy.
Samuel Shing, Undergraduate student, UCSD
Samuel works on Notch inhibition in epidermal development and pathogenesis of cutaneous squamous cell carcinoma.
Andrew Tam, Medical student, UCSF
Andrew works on utilization of Mohs micrographic surgery in the Veterans Affairs healthcare system.
Benjamin Tintera, Undergraduate student, UC Berkeley
Ben works on Notch inhibition in epidermal development and pathogenesis of cutaneous squamous cell carcinoma.