LAUSR

Sir, In the March–April 2019 issue of Indian Journal of Dermatology, Venereology and Leprology, Jain et al. described two rare variants of dermatofibrosarcoma protuberans in two Indian patients.1 It is explicit that various skin disorders are common and cause significant morbidity in individuals infected with human immunodeficiency virus (HIV) and these are often more severe, atypical, and more difficult to treat in comparison to dermatoses in the immunocompetent individuals. Therefore, dermatological examination, laboratory tests, and skin biopsy for histopathological study are essential for sound diagnostic workup of HIV‐related mucocutaneous diseases, considering that an atypical picture occurs in a large proportion of the patients.2 In the light of susceptibility of HIV‐infected patients to develop dermatofibrosarcoma protuberans,3 on one hand, and substantial HIV seroprevalence of 0.26% in India (compared with a global average of 0.2%),4 on the other hand, the contribution of HIV infection to the development of the rare variants would have to be taken into consideration. Hence, ideally. HIV testing and the associated workup of blood CD4 lymphocyte count and viral load measurements would have to be envisaged in the two cases in question.