Abstract
CUTANEOUS MANIFESTATIONS IN HIV INFECTION: A CLINICOPATHOLOGICAL STUDY

Sayeed M. U.*, Rao M. N. and Kumuda C.

ABSTRACT

The first case of Acquired Immunodeficiency Syndrome (AIDS) was reported in Africa. But today India is considered as a new hotbed for this disease. AIDS is caused by a retrovirus human immunodeficiency virus (HIV). Two types of HIV exist: HIV-1 and HIV-2. HIV-1 is more virulent, easily transmitted and is the cause of the majority of HIV infections. On the other hand HIV-2 is less virulent and less transmittable. [1] Skin is commonly affected in the course of HIV infection and in many cases skin findings may the earliest sign of HIV infection. Some are pathognomonic of HIV infection and their presence in a healthy individual mandates HIV investigations. A wide array of dermatological manifestations comprising of bacterial, fungal, viral, and several non-infectious disorders may be evident in HIV infected patient. Most cutaneous complications appear and worsen as disease progresses. The introduction of antiretroviral therapies has declined cutaneous lesions but the severity and spectrum is still present. Our Aim is to study the patterns of Skin lesions in HIV and to correlate this with CD4+ T cell counts. Seropositive HIV patients, patients of all ages and both sexes were included in the study. Seronegative HIV patients were taken as controls. Skin Lesions were sampled by punch biopsy fixed in 10% formalin, processing done and confirmed by histopathology. Skin scrapings were performed in some cases. Total number of HIV positive patients – 188. There were 122 males and 66 females with male: female ratio of 1.8: 1. Number of HIV patients with skin Lesions – 62 (32.98%). There were 48 male s and 18 females with M: F ratio of 2.6: 1. Number of patients who underwent biopsy – 52 (83.87%). Number of Non HIV patients with skin lesions – 1832. We classified cutaneous manifestations into two groups: Infectious and Noninfectious. 51 cases (82.26%) belong to infectious group and remaining 11 cases (17.74%) belong to noninfectious group. Viral infections were the most common lesion encountered in our study in the infectious group. Psoriasis and Contact Dermatitis were common in noninfectious group. Infectious diseases are more common in HIV patients whereas noninfectious diseases were common in Non HIV patients. Molluscum contagiosum is the commonest infectious disease encountered in our study. Genital diseases are also common in HIV and genital Herpes is the commonest genital disease observed in present study. Recognition of cutaneous diseases in HIV helps in early diagnosis and proper management of HIV as well as a measure of the immune status of individual.

Keywords: AIDS, HIV, Skin Lesions, Infectious disorders, Noninfectious disorders.


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