RESUMEN
Background: HIV infection is associated with numerous cutaneous changes even before the onset of immunologic dysfunction and AIDS. We all know that as search for reliable clinical indicators for management of human immunodeficiency syndrome in resource poor settings continues, cutaneous disorder can be a good clinical marker of HIV infection, underlying immune status and the disease progression. Aim and objectives: To study occurrence of various cutaneous manifestations in a patients infected with HIV. Materials and methods: 120 HIV positive patients above 14 year old with definite cutaneous manifestations attending dermatology OPD in Department of Skin, STD and Leprosy, in a tertiary care centre Dehradun were studied from December 2013 to January 2016. Results: Among 120 HIV positive patients in our cross-sectional study highest number of patients belonged to 31-40 years age group. Male to female ratio was 1.9: 1 and heterosexual route was the most common route of transmission. Among all cutaneous manifestations pruritic papular eruption, cutaneous drug reactions, molluscum contagiosum, seborrheic dermatitis were common. 14.17% had more than one cutaneous disorder and they had advanced stage of the disease. Conclusion: Early recognition of the cutaneous manifestation can help in better management of HIV infection in resource poor setting as it can indicate progression of the disease and underlying immune status
RESUMEN
Background: Pruritic papular eruptions (PPE) are common cutaneous manifestations in HIV-infected patients. Their frequencies, patterns and associated factors vary from region to region. There is no clear consensus on the etiology of PPE, the exact spectrum of the condition, the pathologic findings, or treatment. The present study is aimed at documenting the histopathological patterns of PPE, and their relation with CD4, CD8 counts in HIV-infected patients. Materials and Methods: The present study lasted for 12 months (September 2005 to August 2006). After informed consent, data on skin disorders, HIV status, CD4 and CD8 counts were obtained by physical examination and laboratory methods. Results: Of the 36 HIV-infected patients with clinical diagnosis of PPE, the most common histopathological patterns were prurigo simplex and eosinophilic folliculitis. The mean CD4 count of PPE was 186.49 cells/mm 3 with mean CD8 count of 619.60 cells/ mm 3 , and the CD4:CD8 ratio was 0.32. Patients with prurigo simplex had significantly lower mean CD4 counts (50.36 ± 30.67 cells/cmm 3 , P < 0.001) while in eosinophilic folliculitis, the mean CD8 counts were higher (1239.77 ± 402.30 cells/cmm 3 ). Conclusion: We conclude that histopathology helps in specifying the pattern of PPE and also indicates underlying immunosuppression and can be a marker of advanced HIV infection. Thus, correlation between the histopathology and immunology findings helps to know the disease process.