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Mucocutaneous manifestations of human immunodeficiency virus (HIV) infection in children in relation to the degree of immunosuppression
Author(s) -
Britto Gillian R.,
Augustine Mary
Publication year - 2019
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.14440
Subject(s) - medicine , mucocutaneous zone , immunosuppression , human immunodeficiency virus (hiv) , immunology , virology , disease , pathology
Background Human immunodeficiency virus (HIV) infection in children is becoming a common occurrence. Worldwide, limited studies have been done on the mucocutaneous manifestations in HIV ‐positive children. The aim of our study was to analyze the spectrum of mucocutaneous manifestations of pediatric HIV infection and correlate to degree of immunosuppression. Material and methods One hundred and sixty‐five children under 18 years with HIV , who presented to the departments of dermatology and pediatrics, were examined for mucocutaneous manifestations. Patients were classified into four groups of immunodeficiency such as normal, mild, advanced, and severe, based on NACO guidelines of immunosuppression. The most recent CD 4 count (within 6 months of study period) was considered. Results One hundred and sixty‐five patients were examined, and skin manifestations were seen in 100 (61%) of them.The highest incidence of mucocutaneous manifestations was in 6–10 age group. Papular pruritic eruptions ( PPE ) (16%) was the most common condition, with highest prevalence in severe CD 4 category (38%). Molluscum contagiosum (MC) (10%) was the most common infectious condition, with highest prevalence in advanced CD 4 category (14%). Severe cutaneous adverse reactions ( SCAR ) caused by nevirapine were seen in three children. The percentage of skin manifestations was highest in the advanced (107%) and severe (100%) CD 4 category. There was no significant difference in manifestations between those who were on antiretroviral therapy (ART) and those not. Conclusion The percentage of skin manifestations increased with degree of CD 4 depletion. PPE was found to be the hallmark of severe immunosuppression. However, opportunistic infections did not correlate with severity of immunodeficiency.