Nonmelanoma Skin Cancers Treated With Mohs Micrographic Surgery in Patients With HIV: A Cross-Sectional Analysis

Nonmelanoma skin cancers (NMSCs), specifically basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs), are the most common malignancies worldwide. Although the pathogenesis is not well defined, HIV infection is a known risk factor for NMSC. The association between degree of immunosuppression in HIV and development of NMSC remains controversial. One study showed no association with CD4 lymphocyte count, viral load, or highly active antiretroviral therapy (HAART), whereas others demonstrated an association with low CD4 count and high viral load for SCC but not BCC. Depth of invasion is an integral component of staging for NMSC,with invasion.6mmor beyond the subcutaneous fat a high-risk feature for SCC. Mohs micrographic surgery (MMS) is a surgical approach that allows for complete circumferential deep and peripheral margin assessment before reconstruction. Mohs micrographic surgery is particularly beneficial for tumors at high risk for local recurrence with standard excision because of subclinical tumor spread, but it remains underutilized forNMSC in patientswithHIV. In this cross-sectional analysis, we aimed to evaluate the level of invasion, subclinical extension, recurrence rates, tumor staging for SCC, and CD4 count of HIV-positive patients undergoing MMS for NMSC.