Indian J Sex Transm Dis Indian J Sex Transm Dis
Official Publication of the Indian Association for the Study of Sexually Transmitted Disesses
Indian J Sex Transm Dis
The Journal | Search | Ahead Of Print | Current Issue | Archives | Instructions | Subscribe | Login    Users online: 18   Home Email this page Print this page Bookmark this page Decrease font size Default font size Increase font size


 
  Table of Contents  
LETTER TO EDITOR
Year : 2012  |  Volume : 33  |  Issue : 1  |  Page : 65-67
 

Skin diseases in HIV-infected patients: Impact of immune status and histological correlation


1 Department of Dermatology, North Bengal Medical College, West Bengal, India
2 Department of Gynaecology and Obstetrics, North Bengal Medical College, West Bengal, India
3 Department of Pathology, North Bengal Medical College, West Bengal, India

Date of Web Publication14-Mar-2012

Correspondence Address:
Sabyasachi Banerjee
3/1, Haridas Ghosh Road, P.O. Naihati, Dist. 24 Parganas (N) - 743 165, West Bengal
India
Login to access the Email id


DOI: 10.4103/0253-7184.93836

PMID: 22529463

Get Permissions

 



How to cite this article:
Halder S, Banerjee S, Halder A, Pal PR. Skin diseases in HIV-infected patients: Impact of immune status and histological correlation. Indian J Sex Transm Dis 2012;33:65-7

How to cite this URL:
Halder S, Banerjee S, Halder A, Pal PR. Skin diseases in HIV-infected patients: Impact of immune status and histological correlation. Indian J Sex Transm Dis [serial online] 2012 [cited 2014 Apr 16];33:65-7. Available from: http://www.ijstd.org/text.asp?2012/33/1/65/93836


Sir,

Dermatological problems occur in more than 90% of patients with human immunodeficiency virus (HIV) infection. Distinctive skin lesions occur at various WHO clinical stages of HIV infection. Extensive herpes zoster, seborrhoeic dermatitis, and oral candidiasis may act as indicators and their recognition is of particular importance for the early diagnosis of HIV infection and prevention of further opportunistic infections.

In our present study, first 50 of patients, above 14 attending Dermatology OPD who were diagnosed cases of HIV infection but not on ART and whose history, clinical examination data, skin biopsy report, and current CD4 T cell count were available, were included. The data were analyzed using Microsoft excel 2003 data analysis tool and SPSS 16.

Among the patients in this study, 58% (n=29) were male. So, the male to female ratio of this group was 1.38:1. The patients were mostly in 26-35 years age group (50%).

Out of 50 patients, 41 patients (82%, n=41) presented with stage II, 8% (n=4) presented with stage III, and 10% (n=5) presented with stage IV clinical symptoms of HIV disease spectrum (revised WHO clinical staging of HIV/AIDS for adults and adolescents, 2006).

In this study, 96% of the provisional diagnoses given clinically proved to be true after they were verified by histopathological methods.

The commonest dermatological disorder encountered in the present study was pruritic papular eruption (28%), followed by seborrhoeic dermatitis (24%), psoriasis (10%), molluscum contagiosum (10%), and drug reactions (8%). Sivayathorn et al. [1] found in Bangkok in 1995 that pruritic papular eruption (PPE) had a prevalence of 32.7%, SD 21%, and psoriasis 6.5% among HIV seropositives with skin lesion. In an Indian study at Vadodara, 120 out of 200 cases had noninfectious cutaneous manifestations such as pruritic papular eruption in 43 cases (35.8%), pigmentary changes in 10 cases (8.3%), seborrhoeic dermatitis in 5 cases (4.2%), and psoriasis in 4 cases (3.3%). [2]

Eosinophilic folliculitis [Figure 1] is said to occur at CD4 T cell count of 250-300/μl and therefore identifies patients at immediate risk of developing opportunistic infections. [3] Though we found only two cases of EF, their CD4 T cell count (276 and 290/μl) tally with the literature.
Figure 1: Eosinophilic folliculitis

Click here to view


Pruritic papular eruption, [Figure 2] the commonest skin disorder encountered in our study, presents as firm, discrete, sometimes excoriated, erythematous urticarial itchy papules associated with eosinophilia. In the present series, nine patients of PPE had lesions both on extremities and trunk, four had lesions only on extremities, and one had papules over face and arms. That last case was clinically diagnosed as EF but skin biopsy clinched the diagnosis of PPE [Table 1].
Figure 2: Pruritic papular eruption: Itchy tiny erythematous and skin colored papular eruptions mostly on extremities

Click here to view
Table 1: Skin disease distribution in patients of the study population

Click here to view


Definite statistical correlation between some specific skin diseases and CD4 T cell count was found in the present study. HIV-related cutaneous manifestations are very common and can be easily detected. If studied properly, they can serve as diagnostic and prognostic markers [Table 2]. [2]
Table 2: Association between skin diseases and CD4 T cell count of patients

Click here to view


 
   References Top

1.Sivayathorn A, Srihra B, Leesanguankul W. Prevalence of skin disease in patients infected with human immunodeficiency virus in Bangkok, Thailand. Ann Acad Med Singapore 1995;24:528-33.  Back to cited text no. 1
[PUBMED]    
2.Sharma A, Chaudhary D, Modi M, Mistry D, Marfatia YS. Noninfectious cutaneous manifestations of HIV/AIDS. Indian J Sex Transm Dis 2007;28:19-22.  Back to cited text no. 2
  Medknow Journal  
3.Goh BK, Chan RK, Sen P, Theng CT, Tan HH, Wu YJ, et al. Spectrum of skin disorders in human immunodeficiency virus infected patients in Singapore and the relationship to CD4 lymphocyte counts. Int J Dermatol 2007;46:695-9.  Back to cited text no. 3
[PUBMED]  [FULLTEXT]  


    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1], [Table 2]


This article has been cited by
1 Histopathological study of cutaneous manifestations in HIV and AIDS patients
Sharada R. Rane,Preeti B. Agrawal,Nalini V. Kadgi,Meenal V. Jadhav,Shaila C. Puranik
International Journal of Dermatology. 2013; : n/a
[Pubmed]
2 Pattern of mucocutaneous manifestations in human immunodeficiency virus-positive patients in North India
Kore, S., Kanwar, A., Vinay, K., Wanchu, A.
Indian Journal of Sexually Transmitted Diseases. 2013; 34(1): 19-24
[Pubmed]



 

Top
Print this article  Email this article
 

    

 
  Search
 
  
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Article in PDF (842 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  


    References
    Article Figures
    Article Tables

 Article Access Statistics
    Viewed1850    
    Printed45    
    Emailed0    
    PDF Downloaded38    
    Comments [Add]    
    Cited by others 2    

Recommend this journal