Premium
Histopathological study of cutaneous manifestations in HIV and AIDS patients
Author(s) -
Rane Sharada R.,
Agrawal Preeti B.,
Kadgi Nalini V.,
Jadhav Meenal V.,
Puranik Shaila C.
Publication year - 2014
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/ijd.12298
Subject(s) - medicine , folliculitis , molluscum contagiosum , immunopathology , immune system , immunology , dermatology , cd8 , stage (stratigraphy) , disease , pathology , paleontology , biology
Objectives Most human immunodeficiency virus ( HIV )‐infected patients develop various skin diseases. These skin manifestations not only act as markers but also reflect the patient's underlying immune status. Investigating CD 4 counts is costly and not always possible. Thus, the potential value to be gained by using skin manifestations as predictors of low CD 4 counts and disease progression should be explored. The present study attempted to correlate the association of various cutaneous disorders found in HIV patients with CD 4 and CD 8 counts, the CD 4 : CD 8 ratio and stage of HIV infection. Methods This was a prospective study involving 61 patients who were HIV ‐positive and demonstrated skin lesions. Punch biopsies of skin were taken for histopathological diagnosis. CD 4 and CD 8 T cell counts were performed. Results The study sample included a majority of male patients, most of whom were aged 21–40 years. Pruritic papular dermatitis was the most common skin manifestation, followed by molluscum contagiosum, eosinophilic folliculitis, and Hansen's disease. Most of the lesions were associated with CD 4 counts of <220/μl ( n = 38). All skin lesions associated with HIV or acquired immune deficiency syndrome ( AIDS ) showed a CD 4 : CD 8 ratio of <0.50. Conclusions The study findings demonstrate an inverse relationship between CD 4 counts and the occurrence of skin lesions. The majority of lesions were associated with stage 3 or stage 4 infection. Thus, specific cutaneous manifestations can be considered as good clinical indicators for predicting underlying immune status in resource‐poor countries.