The correct answer is A. Sirolimus.

Sirolimus is associated with a decreased risk of developing NMSC and should be considered in a transplant patient who has developed numerous squamous cell carcinomas (pictured).

Each of the remaining answer choices list medications that would make a patient more prone to SCC development.

References:

Dantal J, Morelon E, Rostaing L, Goffin E, Brocard A, Tromme I, Broeders N, Del Marmol V, Chatelet V, Dompmartin A, Kessler M, Serra A, Hofbauer GFL, Kamar N, Pouteil-Noble C, Kanitakis J, Roux A, Decullier E, Euvrard S; TUMORAPA Study Group. Sirolimus for Secondary Prevention of Skin Cancer in Kidney Transplant Recipients: 5-Year Results. J Clin Oncol. 2018 Sep 1;36(25):2612-2620. doi: 10.1200/JCO.2017.76.6691. Epub 2018 Jul 17. PMID: 30016177.

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