Erythrodermic psoriasis and human immunodeficiency virus: association and therapeutic challenges

Abstract: Erythrodermic psoriasis is a rare but severe type of psoriasis that may be triggered by human immunodeficiency virus infection. We describe the case of a 65-year-old male patient with chronic psoriasis who presents an exacerbation of his condition over a period of two weeks. Because of the severity of his case and subsequent need for systemic therapy, human immunodeficiency virus enzyme immunoassay was performed and tested positive. He thus began antiretroviral therapy combined with acitretin, showing good clinical response after 8 weeks of treatment. There is little evidence regarding the management of erythrodermic psoriasis associated with HIV infection, so antiretroviral therapy and systemic retinoid remain as the first-line treatment.

Eritrodermia psoriática en un hombre joven: sospechar infección por VIH / Erythrodermic psoriasis in young man: suspect HIV infection

Resumen La infección por VIH puede presentarse con distintas manifestaciones cutáneas, que en algunas ocasiones son consideradas marcadores de infección. Una posible manifestación es la eritrodermia psoriática, que corresponde a una forma generalizada de psoriasis. Presentamos un caso clínico de un hombre joven en que se sospechó una infección por VIH por un cuadro de eritrodermia psoriática confirmada por biopsia, asociado a un sarcoma de Kaposi. Posteriormente, la infección por VIH fue confirmada por serología. Se manejó con terapia antirretroviral, con buena respuesta al mes de tratamiento. La eritrodermia psoriática se puede considerar un marcador cutáneo de infección por VIH cuando ocurre en pacientes previamente sanos o con psoriasis recalcitrante.

HIV infection can be manifested with different skin symptoms, which are sometimes considered infection markers. Erythrodermic psoriasis is a possible manifestation, which is a widespread form of psoriasis. We report a clinical case of a young man suspected of HIV infection due to a psoriatic erythroderma confirmed by biopsies, associated with Kaposi sarcoma. Afterwards, HIV infection was confirmed by serological tests. Antiretroviral therapy was started, with positive response at one month of treatment. Erythrodermic psoriasis can be considered a skin marker of HIV infection when occurs in previously healthy patients or in recalcitrant psoriasis.

Chronic hepatitis ''C''; a dermatologic perspective

To find spectrum of various dermatological manifestations during hepatitis "C" virus infection in local population of hyderabad. This descriptive study was conducted in medicine department of Isra University Hospital Hyderabad from January 2011 to June 2012. A total of 325 anti-HCV positive patients were enrolled. All patients were subjected to detailed history, careful clinical examination of skin by a dermatologist to diagnose skin disease. All data was analyzed using statistical package SPSS 14.0. A total of 325 HCV positive patients [61% males and 39% females] were enrolled in this study. Mean age was 43 [SD+10 years], ranging from 15 to 78 years. About 41% had one or more dermatologic manifestations. Pruritis was the leading manifestation found in 11%, lichen planus [oral and cutaneous] was next to be found in 6.7% patients and hyperpigmentation in 5.2% patients. Urticaria [acute and chronic] was next counting in 5.23%. Jaundice, alopecia and vitiligo were seen in 4.9% each. Dry skin and interferon injection site erythema were observed in 4.6% patients each. Cutaneous vasculitis was noticed in 3.6% each, while photosensitivity, psoriasis and Raynaud's phenomenon were seen in 1.8%, 2.5%, 1.5% patients respectively. Dermatological manifestations are very common in patients with chronic HCV infection and when confronted with a suspected skin lesion, patient should be screened for it. Epidemiological studies are essential to determine the real prevalence of other dermatoses during course of HCV infection

Hepatitis C and cutaneous alterations / Hepatite C e alterações cutâneas

While most of those infected with hepatitis C virus (HCV) are asymptomatic or only develop liver manifestations, a significant percentage evolves with autoimmune and lymphoproliferative disorders, resulting in a clinical condition called HCV syndrome. This work involving case studies of six patients with hepatitis C and varied skin manifestation aimed to report skin lesions occurring with HCV infection and its treatment. Skin manifestations in hepatitis C have been based on epidemiological studies. This justifies the need for studies that correlate HCV infection and its treatment with skin manifestations.

A maioria dos infectados pelo vírus da hepatite C (VHC) é assintomática ou apresenta somente manifestações hepáticas, porém uma significativa porcentagem evolui com desordens autoimunes e linfoproliferativas resultando na síndrome da hepatite C. Este trabalho envolve seis estudos de casos de pacientes com hepatite C e várias manifestações cutâneas, visando relacionar lesões dermatológicas ao VHC e ao seu tratamento. Manifestações dermatológicas na hepatite C têm sido baseadas em estudos epidemiológicos. Isto justifica a necessidade de estudos que correlacionem infecção pelo VHC e seu tratamento com as manifestações dermatológicas.