Skin carcinoma in 2 patients with HIV infection

KAPOSI SARCOMA (KS) and high-grade non-Hodgkin lymphomas (NHL) are associated with HIV infection [l, 21. The identification of other associated malignancies was predictable in view of the impaired T-cell and natural killer cell function in HIV infection. In fact, an increased number of malignant neoplasms, such as Hodgkin’s disease (HD), testicular cancer, squamous cell carcinoma of the oral cavity and the anorectum, malignant melanoma, adenocarcinomas of the lung, colon, pancreas and kidney and skin carcinoma have been recorded [l-7]. However, of this wide spectrum of malignancies, only KS and high-grade NHL are frequently associated. With the other tumours, some, such as HD, have unusual clinicopathological characteristics and may be more aggressive in HIV infection [3], although there is no epidemiological link between HD and HIV infection. 3 cases of skin carcinoma have been reported in patients with HIV infection: 2 squamous cell and 1 basal cell carcinoma with somewhat different clinicopathological features compared with those in the general population [g-lo]. We report 2 cases of skin carcinoma in HIV patients in our centre in the past 2 years. Case 1 (M/SO, anti-HIV seropositive in 1987 after two negative tests in 1985 and in 1986). ELISA and western blot were positive. An ulcerative lesion in a cicatrix site of a previous wound at the right shoulder appeared at the end of 1987 and increased in size and dimension until August 1989, when biopsy revealed squamous cell carcinoma of the skin. CD4 were 35Oiml and a diagnosis of AIDS according to the Centers for Disease Control (CDC) definition was made on the basis of a wasting syndrome. Radiotherapy with 60 Gy over 30 days was given, with a regression of the lesion. In January 1990, the patient was seen for the first time at our centre for evaluation of the ulcerative lesion of 7 x 6 cm at the right shoulder with lifted margins, irregular and cut borders and necrotic tissue at the bottom; also, a lymphonodal mass of 8 x 5 cm diameter was present in the