Frequency of mucocutaneous manifestations in HIV positive Pakistani patients

Mucocutaneous manifestations are commonly observed in HIV patients. These range from various opportunistic infections, inflammatory dermatoses to neoplasms and drug reactions. To observe the nature and frequency of mucocutaneous manifestations in patients of HIV, with or without antiretroviral therapy and their correlation with CD4 cell counts. The duration of study was one year, starting from July 2009 to July 2010. The patients were enrolled from the HIV clinic and inpatient departments of Jinnah Hospital Lahore. Patients meeting the inclusion and exclusion criteria were subjected to a detailed history and clinical examination. Investigations were carried out where required. Treatment profile was also noted. The data was recorded on a pro forma and was analyzed later. A total of sixty two patients were enrolled in the study. There were 49 [79%] males and 13 [21%] females. The age range was 4 to 58 years. Cutaneous manifestations were seen in 51 [82%] patients. The most common cutaneous findings were fungal infections seen in 33.87% patients, followed by viral infections [29.03%], xerosis [22.58%] and bacterial infections [12.9%]. Less common manifestations were photosensitivity, scabies and hyperpigmentation. CD4 cell count was found to be more than 455xl0[9]/ in 22 patients while it was less than 455xl0[9]/in 40 patients. Skin manifestations were found in 19 [86.36%] patients with a high count and in 33 [82.5%] patients with a low count. Cutaneous manifestations are commonly seen in patients of HIV infection

Role of systemic steroids in the outcome of Stevens-Johnson syndrome and toxic epidermal necrolysis

Stevens-Johnson syndrome [SJS] and toxic epidermal necrolysis [TEN] are cutaneous adverse reactions which usually develop as a result of drug therapy. The role of systemic steroids in the treatment of SJS and TEN is debatable. To see the clinical outcome of patients suffering from SJS or TEN, treated with or without steroids. Forty patients of SJS and TEN were enrolled from the inpatient department of Jinnah Hospital Lahore. Clinical data were recorded on a pro forma. Clinical outcome of patients treated with or without steroids was recorded and analyzed. A total of forty patients were enrolled in the study. Twenty nine patients were suffering from SJS and 11 were suffering from TEN. Twenty three patients of SJS [79.31%] were treated without steroids. Two patients died [8.7%] and twenty one [91.30%] recovered. Six patients were given steroids [20.68%], out of these 2 [33.3%] died and 4 [66.76%] recovered. There were eleven patients of TEN, four [36.37%] were managed without steroids, one expired [25%] and rest of the three [75%] patients recovered. Seven [63.63%] patients were given steroids, three [43.86%] patients expired while four [57.14%] recovered