Qasmi S, Sutra-Loubet C, Maubec E, Boitier F, Duvillard P, Carlotti A, Marinho E, Jacobelli S, Franck N, Gorin I, Vacher-Lavenu M C, Bouscarat F, Crickx B, Dupin N, Avril M F
Service de Dermatologie, Université Paris 5, Hôpital Cochin-pavillon Tornier, 89, rue d'Assas, AP-HP, 75006 Paris, France.
Ann Dermatol Venereol. 2010 Dec;137(12):769-74. doi: 10.1016/j.annder.2010.09.002.
a clinical study of 14 patients presenting both malignant melanoma and HIV infection, and analysis of the literature to determine the frequency and specific features of this association.
ten men and four women of median age 43 years were included. In 50% of cases, the primary melanoma consisted of spreading superficial melanoma with a mean Breslow thickness of 2.83 mm. In two cases, regional lymph node metastasis was discovered but with no primary melanoma being identified. HIV infection was already documented on diagnosis of melanoma in 11 cases, and it was discovered in three cases at the time of surgery for melanoma (treatment of the primary melanoma in two cases, and in one case, regional lymph node dissection two years after the initial diagnosis). Eight patients died within a mean period of 39 months, with melanoma being the cause of death in six cases. Following relapse of melanoma, the course of the disease was severe, with mean stage IV survival of 3.6 months. No response to chemotherapy was observed where such treatment was feasible.
the presence of HIV appears to be an aggravating factor for the outcome of metastatic melanoma.
our study suggests the importance of clinical examination of pigmented lesions in HIV patients in order to ensure early identification of melanoma.
对14例同时患有恶性黑色素瘤和HIV感染的患者进行临床研究,并分析文献以确定这种关联的频率和具体特征。
纳入10名男性和4名女性,中位年龄43岁。50%的病例中,原发性黑色素瘤为浅表扩散性黑色素瘤,平均Breslow厚度为2.83毫米。2例发现区域淋巴结转移,但未发现原发性黑色素瘤。11例黑色素瘤诊断时已记录有HIV感染,3例在黑色素瘤手术时发现(2例为原发性黑色素瘤治疗,1例在初次诊断两年后进行区域淋巴结清扫)。8例患者在平均39个月内死亡,6例死于黑色素瘤。黑色素瘤复发后,疾病进展严重,IV期平均生存期为3.6个月。在可行化疗的情况下未观察到化疗反应。
HIV的存在似乎是转移性黑色素瘤预后的一个加重因素。
我们的研究表明,对HIV患者的色素沉着病变进行临床检查以确保早期发现黑色素瘤很重要。