Cutaneous Malignancies Among HIV-Infected Persons

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Abstract
Cutaneous neoplasms are the most common malignancies in the United States, with 70% to 80% diagnosed as basal cell carcinoma (BCC), followed by squamous cell carcinoma (SCC) and malignant melanoma (MM).1,2 Risk factors include cumulative UV radiation exposure, race, advanced age, reduced DNA repair capability, and immunosuppression.3-6 Multiple studies have demonstrated an increased risk of cutaneous malignancies in immunosuppressed populations. This risk is most pronounced in solid-organ transplant recipients, who have a 65 to 250 times increased risk as compared with the general population.4-6 Patients with human immunodeficiency virus (HIV) infection also have an increased risk of some types of cancer.7-9 Early in the HIV epidemic, Kaposi sarcoma (KS) was the most common malignancy in HIV-positive patients, with a rate that was more than 1000-fold greater than that of the general population.7,10 Because HIV-infected persons have an increased propensity to develop KS as well as non-Hodgkin lymphoma (NHL), these conditions were classified as AIDS-defining cancers (ADCs).11 Since the advent of highly active antiretroviral therapy (HAART), the rate of KS has decreased substantially.12