Lu. Wolfer et al., RAPIDLY PROGRESSIVE METASTATIC MALIGNANT-MELANOMA IN AN HIV PATIENT WITH SEVERE IMMUNOSUPPRESSION AND ATYPICAL NEVUS SYNDROME, EJD. European journal of dermatology, 4(8), 1994, pp. 613-615
The case of a rapidly progressive, metastatic, malignant melanoma in a
n otherwise asymptomatic HIV male patient also presenting atypical nev
us syndrome is described. The primary tumour developed on the left upp
er arm presented Breslow's thickness measuring 5.6 mm and Clark's leve
l V. When the primary tumour was removed HIV antibodies were detected
and immunological investigations revealed 220 CD4+ lymphocytes and a C
D4+/CD8+ lymphocyte ratio of 0.2, but until that time no opportunistic
infections or any other symptoms indicating HIV infection had occurre
d. Four months later the patient showed rapid metastatic spread df his
melanoma starting from the left axillary region where lymph node diss
ection had been performed. X-ray treatment and chemotherapy with vinde
sine plus beta-interferon did not have any beneficial effect. Six week
s later the patient died owing to diffuse metastatic involvement. A re
view of the literature revealed some evidence for Increased melanoma r
isk in immunosuppressed individuals.