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Early warning skin signs in AIDS and persistent generalized lymphadenopathy (PGLS)
Author(s) -
Muhlemann M.F.,
Anderson M.G.,
Paradinas F.J.,
Key P.R.,
Evans B.A.,
Murray Lyon I.M.,
Cream J.J.
Publication year - 1985
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.1985.tb12975.x
Subject(s) - medicine , dermatology , folliculitis , seborrhoeic dermatitis , molluscum contagiosum , impetigo , mycosis fungoides , acne , pathology , lymphoma
Cutaneous manifestations of AIDS include Kaposi's sarcoma, chronic genital herpes simplex, herpes zoster, mucocutaneous candidiasis, fungal infection, pyoderma and seborrhoeic dermatitis. We have consistently seen distinctive patterns of skin disease in male homosexuals with AIDS, PGLS and in a high‐risk group who initially had neither condition. The prevalence of skin disease was assessed in nine patients with AIDS, 15 with PGLS, four in the high‐risk group and in 40 male homosexual patients acting as controls. Three unusual patterns of skin disease were seen in patients with AIDS, PGLS and high‐risk patients that were not seen in the control groups. A florid neck and beard impetigo was present in seven patients; a chronic acneiform folliculitis in ten and extensive fungus infection in nine. Acneiform folliculitis began on the face, back and chest with follicular papulopustules that resembled acne vulgaris. Progression occurred with involvement of the perianal area, buttocks and thighs, often on a background of erythema and xerosis. An axillary folliculitis was present in eight patients. Histology showed a severe chronic lymphohistiocytic perifoUicular inflamma tion. Staphylococcus aureus was isolated occasionally from the AF and always from the impetigo. Relapse following treatment was common. There was extensive infection of the nails, feet, groins and trunk with Trichophyton rubrum. Other skin diseases noted were Kaposi's sarcoma, herpes simplex, herpes zoster, molluscum contagiosum, warts, candidiasis, vasculitis, eczema, seborrhoeic dermatitis, leukonychia and leukoplakia. In contrast the control group had no distinctive skin signs. Tinea pedis was present in four and genital warts in five patients. In male homosexuals we now view with concern the development of chronic acneiform folliculitis, neck and beard impetigo and intractable fungus infection.