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Introduction: Acquired epidermodysplasia verruciformis (EV) is a skin disorder that has been described in individuals with perinatally acquired HIV. Many cases have been identified in sub-Saharan Africa in keeping with the epidemiology of HIV infection compared to the rest of the world, where cases are rare. Epidermodysplasia verruciformis skin lesions may undergo malignant transformation. There are few documented cases of malignant transformation of these skin lesions. We describe a patient with an EV-like skin rash who developed cutaneous squamous cell carcinoma (SCC). Patient presentation: A 25-year-old man, on antiretroviral treatment for 12 years, presented with a generalised skin rash since the age of 11 years, and a 7-month history of a persistent scalp ulcer. He had no history of trauma, radiation or other chronic conditions. Despite an undetectable HIV viral load, he had failed to immune reconstitute (CD4 42 cells/µL). Physical examination revealed a generalised hypopigmented, papular skin rash resembling verruca plana and a 3 cm × 3 cm ulcer with rolled edges on the right parietal region of the scalp. There were no palpable lymph nodes in the head and neck areas. Biopsy of the ulcer revealed moderately differentiated SCC. Management and outcome: Wide local excision of the lesion was done under local anaesthesia and histological analysis confirmed completely excised moderately differentiated SCC. Further examination four weeks later revealed two, smaller, histologically similar scalp lesions which were completely excised. Conclusion: Patients with acquired EV require thorough, frequent examination for skin lesions with possible malignant transformation. Early identification of malignant transformation and treatment with surgical intervention is curative. [ABSTRACT FROM AUTHOR]

Background: Women living with HIV (WLWH) are six times more likely to develop cervical cancer (CC). There is also an increased incidence of CC in women with optimal HIV disease control, despite immune reconstitution due to antiretroviral therapy (ART). Objectives: This study describes the prevalence and age-specific genotype distribution of hrHPV among an urban cohort of WLWH. Additionally, we report the HIV disease profile and age-specific outcomes of hrHPV DNA screening in WLWH attending routine CC screening at Newlands Clinic, Harare, between January and December 2021. Method: This was a descriptive cross-sectional design based on a retrospective review of records of WLWH who were screened for hrHPV infection. We assessed the prevalence of hrHPV infection during the study period. Results: We included data for 2745 women who had an hrHPV DNA test. The median age at the time of testing was 45 years (interquartile range [IQR]; 37-52) The median duration on HIV ART was 10.2 years (IQR: 6.2-13.3). The proportion of women with undetectable viral loads (< 50 copies/mL) was 91.2%. The prevalence of hrHPV infection was 53%. The most prevalent genotypes were human papillomavirus (HPV) 58 (11%), HPV 52 (10%), HPV 35 (10%), and HPV 16 (9%). Conclusion: Our study reports a high prevalence of HPV and hrHPV including other subtypes than 16 and 18. These results highlight the continued importance of CC screening and prophylactic HPV vaccinations among WLWH. [ABSTRACT FROM AUTHOR]