Study of cutaneous manifestation of HIV disease in correlation with CD4 lymphocyte count

Authors

  • Neeti Kumari Department of Dermatology, Shri Guru Ram Rai Institute of Medical and Health Science, Dehradun, Uttarakhand,
  • Kewal Krishan Department of Dermatology, Shri Guru Ram Rai Institute of Medical and Health Science, Dehradun, Uttarakhand,
  • Jatinder Singh Bist Department of Dermatology, Shri Guru Ram Rai Institute of Medical and Health Science, Dehradun, Uttarakhand,
  • Anil Kumar Mehta Department of Dermatology, Shri Guru Ram Rai Institute of Medical and Health Science, Dehradun, Uttarakhand,

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20193234

Keywords:

HIV, Cutaneous manifestations, CD4 cell counts

Abstract

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 considered among key clinical indicators for prediction of underlying immune status and disease progression. To study occurrence of various cutaneous manifestations and its correlation with CD4 cell counts in HIV infected Patients.

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 (Uttarakhand, India) were studied from December 2013 to January 2016.

Results: Among 120 HIV positive patients in our cross-sectional study, 50.83% of patients belonged to 31-40 years age group. Male to female ratio was 1.9:1 and heterosexual route was most common route of transmission. 69.17% of our study population had CD4 cell counts below 200 cells/mm3 and 23.33% of patients had CD4 cell counts <50 cells/mm3. Among these, commonest cutaneous manifestations were pruritic papular eruption, cutaneous drug reactions, molluscum contagiosum, seborrheic dermatitis. 17 patients (14.17%) had more than one cutaneous disorder with mean CD4 cell count of 121.5 cells/mm3 indicating advanced stage.

Conclusions: At the end of study we concluded that cutaneous manifestations can be considered as a good clinical indicators for the progression of disease and underlying immune status in resource poor setting. 

References

Coldiron BM, Bergstresser PR. Prevalence and clinical spectrum of skin disease in patients with HIV. Arch Dermatol. 1998;125:357-61.

Tripathy S. Classification and staging of HIV disease. In: Vinay Kulkarni, Prayas (eds). HIV/AIDS: Diagnosis and Management. 1st edition. 1999: 85-96.

Schwartzman W, Lambertus MW, Kennedy CA, Goetz MB. Staphylococcal pyomyositis in patients infected by HIV. Am J Med. 1991;90:595-600.

Wiwanitkit V. Prevalence of dermatological disorders in Thai HIV-infected patients correlated with different CD4 lymphocyte count statuses: A note on 120 cases. Int J Dermatol. 2004;43:265-8.

Kumarswamy N, Solomon S, Madhivanan P, Ravikumar B, Thyagarajan SP, Yesudian P. Dermatologic manifestations among HIV patients in South India. Int J Dermatol. 2000;39:192-5.

Sharma YK, Sawhney MPS, Bhakuni DS, Gera V. Orocutaneous manifestations as markers of disease progression in HIV infection in Indian setting. MJAFI. 2004;60:239-43.

Smith KJ, Skelton HG, Yeager J, Ledsky R, McCarthy W, Baxter D, et al. Cutaneous findings in HIV-1 positive patients: a 42 month prospective study. J Am Acad Dermatol. 1994;31:746.

Raju PV, Rao GR, Ramani TV, Vandana S. Skin disease: Clinical indicator of immune status in HIV infection. Int J Dermatol. 2005;44:646-49.

Bhandary PG, Kamath NK, Pai GS, Rao G. Cutaneous manifestations of HIV infection. Indian J Dermatol Venereol Leprol. 1997;63:35-7.

Singh A, Thappa MD, Hamide A. The spectrum of mucocutaneous manifestations during the evolutionary phases of HIV disease: an emerging Indian scenario. J Dermatol. 1999;26(5):294-304.

Chacko S, John TJ, Babu PG, Jacob M, Kaur A, Mathai D. Clinical profile of AIDS in India: a review of 61 cases. J Associ Phys India. 1995;43(8):535-8.

Liautaud B, Pape JW, DeHovitz JA, Thomas F, LaRoche AC, Verdier RI, et al. Pruritic skin lesions: A common initial presentation of AIDS. Arch Dermatol. 1989;125:629-32.

Goldstein B, Berman B, Sukenik E, Frankel SJ. Correlation of skin disorders with CD4 lymphocyte counts in patient with HIV/AIDS. J Am Acad Dermatol. 1997;36(2):262-4.

Spira R, Mignard M, Doutre MS, Morlat P, Dabis F. Prevalence of cutaneous disorders in a population of HIV- infected patients. Arch Dermatol. 1998;134:1208-12.

Pereira GA, Stefani MM, Araújo Filho JA, Souza LC, Stefani GP, Martelli CM. HIV-I and Mycobacterium leprae co-infection: HIV–I subtypes and clinical, immunologic and histopathologic profiles in a Brazilian cohort. Am J Trop Med Hyg. 2004;71(5):679-84.

Lienhardt C, Kamate B, Jamet P, Tounkara A, Faye OC, Sow SO et al. Effect of HIV infection on leprosy: a three year survey in Bamako Mali. Int J Lepr other Mycobact Dis. 1996;64(4):383-91.

Mitsuyasu R, Groopman J, Volberding P. Cutaneous reaction to trimethoprim-sulfamethoxazole in patients with AIDS and Kaposi’s sarcoma. N Eng J Med. 1998;30:1535-6.

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Published

2019-07-24

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Original Research Articles