To illustrate the potential for aggressive growth of cutaneous squamous
cell carcinomas (SCCs) in patients infected with the human immunodeficiency
virus (HIV) and to determine the factors associated with increased morbidity
and mortality from aggressive SCCs in HIV-infected patients.
Retrospective nonrandomized case series.
University-based dermatologic referral center.
A consecutive sample of 10 patients infected with HIV who had "aggressive"
SCC based on the following criteria: diameter larger than 1.5 cm, rapid growth
rate, local recurrence, and/or evidence of metastasis.
Main Outcome Measures
Morbidity and mortality.
Five patients died of metastatic SCC within 7 years of their initial
diagnosis despite treatment. Human immunodeficiency virus stage and the degree
of immunosuppression were not associated with increased morbidity and mortality.
Patients initially undergoing combination surgery and radiation therapy or
radical neck dissection had the best outcomes.
Patients infected with HIV can develop rapidly growing cutaneous SCCs
at a young age, with a high risk of local recurrence and metastasis. High-risk
SCCs should be managed aggressively and not palliatively in patients infected