EXCESS OF NEVI RELATED TO IMMUNODEFICIENCY - A STUDY IN HIV-INFECTED PATIENTS AND RENAL-TRANSPLANT RECIPIENTS

To assess the relationship between immune system and nevi, we studied two models of immunodeficiency caused by different mechanisms, i.e., v irus and drug. Our rationale was that if an excess of nevi was found i n these two epidemiologic models, it could be concluded that the exces s was due to immunodeficiency itself rather than its cause. One hundre d ten renal transplant recipients (RTR) were compared with age-, sex-, and phenotype-matched controls, Eighty four HIV-positive patients (HI V+) were compared with similarly matched controls, Nevi < 5 mm (N < 5) or greater than or equal to 5 mm (N greater than or equal to 5) were counted in three sites representative of regularly, intermittently, an d never sun-exposed sites, The number of N < 5 was higher in RTR (p < 0.001) and in HIV+ (p < 0.001) than in respective controls, N greater than or equal to 5 were significantly higher only in RTR, These differ ences tended to be the same for all sites and persisted after adjustme nt for possible confounding factors, The incidence of atypical nevus w as higher in RTR than in controls, Immunodeficiency seems to promote t he occurrence of nevi, This supports the concept of immune surveillanc e of nevi and raises the question of whether sun-induced immune suppre ssion plays a role in the development of nevi. As nevi are risk marker s for melanoma, a higher incidence of melanoma could be expected in im munocompromised patients.