Skin cancer and HIV

Area of Science:

• Dermatology
• Infectious Diseases
• Oncology

Background:

• The incidence of skin cancer in persons living with HIV (PLWH) is influenced by antiretroviral therapy (ART).
• While keratinocyte carcinomas are common in both PLWH and the general population, PLWH may have an elevated risk for squamous cell carcinoma.
• Merkel cell carcinoma and sebaceous carcinoma show increased incidence rates among PLWH.

Purpose of the Study:

• To review the current understanding of skin cancer risks in PLWH.
• To discuss the impact of HIV, ART, and immune status on skin cancer development and treatment.
• To highlight the need for specific screening and treatment guidelines for this population.

Main Methods:

• Literature review of studies investigating skin cancer incidence, risk factors, and treatment outcomes in PLWH.
• Analysis of the interplay between HIV infection, antiretroviral therapy, immune status, and skin carcinogenesis.
• Examination of current screening recommendations and therapeutic approaches, including Mohs micrographic surgery and immune checkpoint inhibitors.

Main Results:

• PLWH may experience a higher risk of squamous cell carcinoma compared to the general population.
• Increased incidence rates of Merkel cell carcinoma and sebaceous carcinoma are observed in PLWH.
• Data regarding melanoma risk in PLWH are inconsistent.
• Immune checkpoint inhibitors appear safe and effective in PLWH, though further research is needed.

Conclusions:

• The risk of skin cancer in PLWH is multifactorial, influenced by HIV, ART, and immune status.
• Vigilant surveillance, tailored screening, and specific treatment guidelines are crucial for managing skin cancer in PLWH.
• Further research is essential to refine understanding and management strategies for skin cancer in this population.