Ultraviolet light exposure, aging, HPV infection, smoking, fair complexion, and immunosuppression play a role in the development of OSSN. Rapid growth may occur when the lesion is present in a person with AIDS. Systemic immunosuppression seems to potentiate squamous neoplasia. In a young adult, OSSN should prompt consideration of a serologic test for human immunodeficiency virus (HIV) infection.
Kamal S, Kaliki S, Mishra D, Batra J, Naik MN. Ocular Surface Squamous Neoplasia in 200 Patients. A case-control study of immunosuppression resulting from human immunodeficiency virus versus immunocompetency. Ophthalmology. 2015;122(8): 1688–1694.
Shields CL, Ramasubramanian A, Mellen PL, Shields JA. Conjunctival squamous cell carcinoma arising in immunosuppressed patients (organ transplant, human immunodeficiency virus infection). Ophthalmology. 2011;118(11):2133–2137.