RESUMO
Several previous studies have yielded data showing that plantar and other cutaneous verrucae follow a more aggressive course in patients infected with human immunodeficiency virus (HIV) than in uninfected individuals. A pilot study was undertaken to identify trends in a sample population that would support this characterization of plantar verrucae in HIV+ patients and to determine whether there are differences in treatment response between HIV+ and HIV- patients. The results show that the HIV+ patients in the study presented with a significantly greater number and total area of lesions than did the HIV- patients. Furthermore, the HIV+ patients experienced a greater frequency of recurrence of their lesions following treatment with surgical curettage. These findings should provide the foundation for other extensive, multicenter studies to further characterize the treatment response of these lesions in HIV+ patients and to develop effective guidelines for their management.
Assuntos
Doenças do Pé/complicações , Doenças do Pé/terapia , Soropositividade para HIV/complicações , Verrugas/complicações , Verrugas/terapia , Colódio/uso terapêutico , Curetagem , Fármacos Dermatológicos/uso terapêutico , Combinação de Medicamentos , Soronegatividade para HIV , Humanos , Lactatos/uso terapêutico , Projetos Piloto , Salicilatos/uso terapêutico , São Francisco , Resultado do TratamentoRESUMO
Plantar verrucae, caused by human papillomavirus (HPV), are commonly found in patients who have tested positive for the antibodies to human immunodeficiency virus (HIV). A better understanding of the characteristics of plantar verrucae in HIV+ patients in needed. A pilot study was conducted concentrating on three characteristics--the size, the number, and the clinical type--of verrucae present in this population. These parameters were studied in HIV+ and HIV- populations, and they were evaluated in relation to the CD4 levels of HIV+ individuals. The HIV+ individuals presented with plantar verrucae that were larger and more numerous than those found in HIV- individuals. The HIV+ population presented with all three clinical types of plantar verrucae and had significantly more mosaic-type warts than did HIV- individuals. The three characteristics did not correlate with CD4 cell counts, suggesting that the severity and extent of HPV infection do not depend on the level of immunosuppression of the HIV+ patient.
Assuntos
Doenças do Pé/complicações , Doenças do Pé/virologia , Soropositividade para HIV/complicações , Verrugas/complicações , Verrugas/virologia , Adulto , Contagem de Linfócito CD4 , Feminino , Doenças do Pé/imunologia , Soropositividade para HIV/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , São Francisco , Verrugas/imunologiaRESUMO
Onychomycosis is a common podiatric condition that has become an increasing problem as the number of patients with HIV infection has grown. Although it is not among the most severe infections that affect HIV-positive patients, it tends to be more extensive, refractory to treatment, and has a unique clinical presentation in this patient population. It is important for the podiatric physician to be aware of the epidemiology, clinical presentation, diagnosis, and treatment of onychomycosis in HIV-positive patients.
