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HIV & skin cancer; Are they related?
Mar 13, 2002

I have been HIV for 17 years, and still not on meds. VL around 60,000 for the past 10 years and CD4's around 300 for the past 10 years. 7 years ago, I had a melanoma on my forearm which was removed. This year I had my second one on my cheek. I have had 3 squamous cell and 4 basal cell cancers removed. I am about to do an acid peel on my face and arms with fluorouracil (Efudex). My health care provider (Veterns Admin.) is suggesting that my skin cancer is directly related to my HIV disease. What is your opinion? I lived at the beach most of my life, and fried my skin (baby oil/iodine) . I am going to be 67. I have never had a presentation other than the skin cancers. No night sweats, weight loss, fatigue, etc. I am very very healthy.

Response from Dr. Dezube

Wow! That sure is alot of skin cancer, and of all the major varieties-- melanoma, basal cell, and squamous. The answer to your question as to whether the skin cancers are related to your HIV disease is "Yes and No". Most patients with these skin cancers have a history of excessive sun exposure just like yours, so the real culprit is sun damage, not HIV. HOWEVER, patients with HIV are more prone to these skin cancers. So although HIV is perhaps not causing the cancer directly, the immunosuppression caused by HIV acts like a fertilizer and makes these cancers occur more frequently and behave more aggressively. In other words, HIV contributes indirectly to these cancers. Although you did not ask whether you will be less prone to skin cancers if you treat your underlying HIV disease, my hunch is that HIV treatment may indeed help make your skin cancers less aggressive. Whether or not you decide to take HIV treatment, it is imperative that each of these skin cancers be taken care of. Good Luck. BD

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