What chemoprophylaxis, if any, would you consider in a transplant patient with numerous KC/NMSCs?

Besides treating actinic keratoses with all methods available to try to prevent their progression, acitretin is #1 in my book for these patients. It’s best to get them on it before they reach the point of developing big, bad SCCs. Dosing is based on patient size and tolerance. Start with 10 mg per day (or every other day for a small person). Larger patients generally require work up to 25 mg daily for best effect, but smaller patients and those who cannot tolerate higher doses will benefit from just 10 mg.

I have not been impressed by niacinamide in immune-competent or compromised patients.

Addendum (10/25): Given the beneficial results of the recent study of VA patients on nicotinamide, I am now recommending it to most of my skin cancer p...