title: Impaired cell-mediated immunity of apparently normal patients who had multiple skin cancers.
abstract: BACKGROUND
  Investigations of the immune status of patients with skin cancer have had conflicting results, possibly because uniform groups of patients were not studied. Patients who had multiple skin cancers (three or more) were studied to determine whether they had impaired cell-mediated immunity (CMI).
  
  
  METHODS
  Thirty-four patients and 34 matched control subjects were studied who were younger than 60 years, were not immunosuppressed, and were free from internal cancer. Cell-mediated immunity was tested by the cutaneous reaction to recall antigens (Multitest CMI, Pasteur Merieux, Lyon, France) and the estimation of lymphocyte levels.
  
  
  RESULTS
  Patients had significantly lower Multitest CMI scores (P < 0.0005), lower lymphocyte counts (P < 0.02), and were more likely to have a first-degree relative with skin cancer (P < 0.002). Multitest CMI scores decreased with the number of skin cancers removed (P < 0.0006) and were a significant predictor for CD4 (P < 0.04) and CD8 cell counts (P < 0.02).
  
  
  CONCLUSIONS
  Patients who had multiple skin cancers had impaired CMI, and the degree of impairment correlated with the number of skin cancers removed.
authors.affiliation: Austin and Repatriation Medical Centre, Melbourne, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Czarnecki
authors.forename: J
authors.initials: J
authors.lastname: Zalcberg
authors.forename: E
authors.initials: E
authors.lastname: Kulinskáya
authors.forename: T
authors.initials: T
authors.lastname: Kay
mesh_terms: D000328:Adult; D000368:Aged; D018791:CD4 Lymphocyte Count; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed; D007111:Immunity, Cellular; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000276:immunology*; D012878:Skin Neoplasms / Q000276:immunology*; D012882:Skin Tests