Retina & vitreous · practice question
Investigation: [READINESS SEED] A 32-year-old man has an aggressive, rapidly enlarging…
[READINESS SEED] A 32-year-old man has an aggressive, rapidly enlarging periocular squamous cell carcinoma; a colleague separately describes a patient with violaceous cutaneous nodules that prove to be Kaposi sarcoma. Which investigation is most important to add?
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Answer: A. Testing for HIV infection
Cutaneous squamous cell carcinoma that occurs in a young patient or behaves unusually aggressively — and Kaposi sarcoma at any age — should prompt testing for HIV and other causes of immunosuppression. Immunosuppression markedly worsens the behaviour of periocular squamous cell carcinoma, raising the risk of recurrence, perineural and nodal spread, and metastasis, so identifying it changes both treatment intensity and surveillance.
Clinical pearl: An "out-of-context" cutaneous malignancy — SCC in the young, or Kaposi sarcoma — is a cue to check immune status (HIV, transplant, iatrogenic immunosuppression). # Eyelid — reconstruction & aesthetics