We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Cutaneous Squamous Cell Carcinoma in Human Immunodeficiency Virus-Infected Patients A Study of Epidemiologic Risk Factors, Human Papillomavirus, and p53 Expression

Toby A. Maurer, MD; Kirsten Vin Christian, MD; Russell L. Kerschmann, MD; Bella Berzin, MD; Joel M. Palefsky, MD; Deborah Payne, PhD; Stephen K. Tyring, MD; Timothy G. Berger, MD
Arch Dermatol. 1997;133(5):577-583. doi:10.1001/archderm.1997.03890410031004.
Text Size: A A A
Published online


Objective:  To examine risk factors for the development of cutaneous squamous cell carcinoma (SCC) in a group of human immunodeficiency virus (HIV)— infected patients, including evaluation and detection of epidemiologic risk factors of human papillomavirus (HPV) and p53 expression.

Design:  Case-control study during a 3-year period.

Setting:  Dermatologic referral center.

Patients:  Thirty-three HIV-infected patients who had 97 SCCs were compared with 24 HIV-infected patients who had 70 basal cell carcinomas (BCCs).

Main Outcome Measures:  Age, skin type, amount of sun exposure, actinic damage, family history of skin cancer and history of smoking and warts. Specimens of SCC and BCC were examined for HPV using polymerase chain reaction. Presence of p53 was examined using immunohistochemical analysis. Specimens from tumor-free, non—sun-exposed areas from these same patients were used as controls.

Results:  Risk factors for the development of both types of carcinoma included fair skin type and excessive sun exposure (>6 h/d during the previous 10 years). The HIV-infected patients with SCCs tended to have outdoor occupations. The location of SCCs favored the head and neck; BCCs were located on the trunk. Patients with SCCs had later-stage HIV disease than did patients with BCCs. Half of the patients with SCC had a history of genital or nongenital warts. Seventy-one percent (17/24) had a smoking history. No statistical difference existed between patients with SCCs and BCCs for history of smoking or warts. Human papillomavirus was not found in most of our SCC, BCC, or control specimens. However, 92% (22/24) of the SCC specimens and 90% (18/20) of the BCC specimens stained for p53. Control specimens from non—sun-exposed skin of HIV-infected patients did not stain for p53. Epidermal staining was present in 95% (17/20) of tissue adjacent to SCCs and 47% (7/15) of tissue adjacent to BCCs. A significantly positive correlation existed between the amount of sun exposure and the amount of p53 staining seen in adjacent epidermal tissue (r=0.07; P=.01).

Conclusions:  Risk factors for the development of SCCs and BCCs in HIV-infected patients are similar: fair skin type and excessive sun exposure. Our study does not support that HPV is an oncogenic factor in the development of these cutaneous tumors but provides evidence that p53 overexpression may play a role.Arch Dermatol. 1997;133:577-583


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.