Abstract
BackgroundWe present an unusual case of a patient who developed four melanomas within a few months of diagnosis with human immunodeficiency virus and commencement of highly active antiretroviral therapy therapy. The patient had no previous history of melanoma, and previous skin checks were normal.Case presentationA 50-year-old Caucasian male drainlayer with Fitzpatrick type 2 skin presented for a routine skin examination. He had been diagnosed with human immunodeficiency virus 4 months earlier and commenced on highly active antiretroviral therapy therapy. He was found to have three melanomas (melanoma in situ stage) on excision biopsies, and when he presented for wider excisions of these sites a few weeks later, another new melanoma in situ was found. He had no other medical history of note, and no symptoms to report. He is being followed up 3-monthly.ConclusionsThis case of a human immunodeficiency virus-positive person presenting with four cutaneous melanomas—occurring in both synchronous and metachronous fashion within a 4-month period—is being presented both for its uniqueness and also to highlight the increased need for close skin surveillance in human immunodeficiency virus-positive patients.
Highlights
Human immunodeficiency virus (HIV) infection has been associated with skin manifestations of cancers such as Kaposi’s sarcoma and non-Hodgkin’s lymphoma
We present an unusual case of a patient who developed four melanomas within a few months of diagnosis of HIV and commencement of highly active antiretroviral therapy (HAART) therapy
While patients with multiple primary invasive melanomas are at increased risk of death compared with patients with single primary invasive melanomas, it is interesting that for patients with melanoma in situ (MIS), those with multiple lesions appear to have better outcomes when compared with patients with a single MIS [3]
Summary
This case of a human immunodeficiency virus-positive person presenting with four cutaneous melanomas—occurring in both synchronous and metachronous fashion within a 4-month period—is being presented both for its uniqueness and to highlight the increased need for close skin surveillance in human immunodeficiency virus-positive patients
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