Mucocutaneous manifestations in 150 HIV-infected Indian patients and their relationship with CD4 lymphocyte counts

Abstract

Mucocutaneous findings in 150 HIV+ve cases (F, 79; M, 71) were evaluated over a one-year period. Mucocutaneous manifestations were seen in 96% with 2.9 mean number of dermatoses and mean cluster of differentiation (CD4) count of 196.33 cells/mm(3). The highest number of mean dermatoses, 3.29, was seen in individuals with severe immunosuppression. The most common mucocutaneous manifestation seen was candidiasis (35.33%), followed by seborrhoeic dermatitis (31.33%), oral pigmentation (29.33%), xerosis/ichthyosis (22.67%), pyodermas (22%), periodontitis (17.33%) and nail pigmentation (16.67%). Patient stratification according to the WHO immunological staging, according to CD4 counts, showed a statistically significant association (P < 0.05) for candidiasis, scabies, paronychia, oral pigmentation and diffuse hair loss. Nail and oral pigmentary changes, trichomegaly and subcutaneous fungal infections caused by dermatophytes were highlights of the study. Incidences of xerosis/ichthyosis, pyodermas, scabies and molluscum contagiosum reported in our study were higher and pruritic popular eruptions was lower than those in previous Indian studies. Cutaneous neoplasms were not seen in the present study.

Skin and Mucocutaneous Manifestations: Useful Clinical Predictors of HIV/AIDS

“…The co-infection of HIV with Candida may be an important exogenous factor that may influence the severity and the rate of the disease progression in HIV infected individuals [12]. In the present study, oral candidiasis (32.22%) was the most common mucocutaneous manifestation which was seen in the HIV positive persons, which collaborated with the findings of other workers (35.33%) [13]. It was reported to be 61% in another study which was done in the same institution [14] (p<0.001), whereas other workers had reported it to be 45% and 11.50% respectively [15,11].…”

“…A papular pruritic eruption is a unique dermatosis which is associated with the advanced HIV infection, which is characterized by sterile papules, nodules, or pustules with a hyperpigmented, urticarial appearance and pruritis [27]. The next common manifestations were gingivitis and apathus stomatitis (4.44%) each, whereas other workers reported it to be 82.9%, 17.33% and 3% respectively [22,13,3]. Severe periodontal diseases have been associated with the alterations in the host immune system, which can predispose to gingivitis and the development of periodontitis.…”

Evaluation of Oral Health Status as an Indicator of Disease Progression in HIV Positive Children

“…Some common problems associated with HIV/AIDS are development of fever, blisters, Kaposi's sarcoma, oral warts, canker soars, oral hairy leukoplakia, gingival and periodontal diseases, thrush, swelling in salivary glands, enlarged lymph nodes, dry mouth, viral oral lesions and herpes simplex lesions etc 5,18,19 . The side eff ects of medicati ons commonly used may also aff ect the oral health.…”

Prevalence of oral lesions in HIV infected adult population of Mangalore, Karnataka, India

“…Some oral lesions may even Oral lesions and immunosuppression in HIV patients affect patient's quality of life [6]. Early diagnosis and appropriate treatment of oral lesions have great influence on patients' general health and can reduce the mortality rate of the disease [7]. Reduction of circulating CD4 count is the main criteria for assessing the immunosuppression status in HIV-positive patients.…”

“…Most of the patients with oral candidiasis were suffering from severe immunosuppression, and they concluded that candidiasis and gingivitis could be considered as an indicator of the disease progression [4]. The research work conducted by Sud et al and Nokta have also shown an association between low CD4 counts and candidiasis, linear gingival erythema, angular cheilitis, scabies, paronychia, oral pigmentation, diffuse hair loss and other oral symptoms [7,8].…”