title: Aggressive squamous cell carcinomas in persons infected with the human immunodeficiency virus.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Retrospective nonrandomized case series.
  
  
  METHODS
  University-based dermatologic referral center.
  
  
  METHODS
  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.
  
  
  METHODS
  Morbidity and mortality.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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 with HIV.
authors.affiliation: Department of Dermatology, University of California, San Francisco, CA 94143, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Nguyen
authors.forename: Kirsten
authors.initials: K
authors.lastname: Vin-Christian
authors.forename: Michael E
authors.initials: ME
authors.lastname: Ming
authors.forename: Timothy
authors.initials: T
authors.lastname: Berger
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000276:immunology* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000276:immunology* / Q000628:therapy; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D008297:Male; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012494:Sampling Studies; D012720:Severity of Illness Index; D012878:Skin Neoplasms / Q000276:immunology* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D015996:Survival Rate