Five cases of melanoma in HIV positive patients

Kaposi's sarcoma, high grade B-cell non-Hodgkin lymphoma and invasive carcinoma of the cervix are all AIDS-defining illnesses according to the CDC staging criteria classification. A number of other malignancies, not traditionally associated with HIV infection, such as Hodgkin's disease, cancers of the rectum, anus, and germ-cell tumours, appear to occur more often than would be expected in these patients. Malignant cutaneous lesions, including basal cell, squamous-cell carcinomas, Bowen's disease, and cutaneous melanoma (CM) have been less often reported.

We retrospectively evaluated the clinical data of 5 HIV+ seropositive patients and CM observed at the "M. Bufalini" Hospital, Cesena, Italy from 1994 to 2000.

All the 5 subjects had a history of intense sun exposure and sunburns. Four patients reported homosexuality as their risk factor for HIV disease. Reviewing the international literature on the subject HIV infected homosexuals appear the group at higher risk of developing CMM, accounting for 80% of cases.

As patients' life expectancy appears to be prolonged after the advent of the HAART therapy, skin cancers will probably become more frequent in the near future. Clinicians should keep close medical surveillance to promptly diagnose new cases of melanoma and non-melanoma skin cancers and advise their HIV-infected patients on the risk of prolonged sun exposure and severe sun burns for the development of skin cancers.