Low CD4+ T-cell nadir as a preoperative risk factor for squamous cell carcinoma with larger surgical margins during Mohs micrographic surgery among patients infected with HIV

Abstract

To the Editor: Patients with HIV are uniquely immunosuppressed and have a significantly increased risk of nonmelanoma skin cancer compared with the general population1,2 despite antiviral therapy.3 Preoperative prognostic risk factors that may predict the need for extensive Mohs micrographic surgery (MMS) for nonmelanoma skin cancer are not known. The objective of this study was to determine whether a CD4+ T-cell count nadir of less than 200 cells/μL (CD4<200) is an independent risk factor for larger surgical margins for the treatment of squamous (SCC) and basal cell carcinomas (BCC) in patients with HIV.