Dermatological Manifestations In Human Immunodeficiency Virus Infected Patients: Histopathology And CD4 Cell Count Correlation
Keywords:
CD4, histopathology, human immunodeficiency virus, punch biopsy, skin lesions
Abstract
Background:More than 90% of the Human immunodeficiency virus (HIV) infected patients develop skin lesions at some point throughout the course of the disease. Although these conditions may be seen in general healthy population, their occurrence in patients with acquired immunodeficiency syndrome is often atypical, more severe and explosive. Histopathology study of skin biopsies from these lesions is very useful for the final diagnosis of these lesions.Methods :Total 60cases were studied. Punch biopsies from the skin lesions were studied with routine histopathology examination and special stains were used as and when required. The results were divided into infectious and non-infectious categories. Results were correlated with the CD4 counts of the patientsResults :Out of that 22 (36.66%) patients had infectious lesions and 38 (63.33%) patients had non-infectious lesions. The spectrum of various non-infectious and infectious lesions such as viral, bacterial, fungal, protozoa, dermatitis, popular lesions and their association with CD4 counts is discussed.Conclusion: In present study mean CD4 cell count was found to be low (<350) in individuals with infectious skin lesions, where as non-infectious lesions were associated with higher (>350) CD4 cell counts.DOI: 10.21276/APALM.1538References
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13. Nichols L, Balogh K, Silverman M. Bacterial infections in the acquired immune deficiency syndrome. Clinicopathologic correlations in a series of autopsy cases. Am J Clin Pathol. 1989;92:787–90.
14. Dover JS, Johnson RA. Cutaneous manifestations of human immunodeficiency virus infection. Part II. Arch Dermatol. 1991;127:1549–58.
15. Inserra DW, Bickley LK. Crusted scabies in acquired immunodeficiency syndrome. Int J Dermatol. 1990;29:287–9.
16. Hevia O, Jimenez-Acosta F, Ceballos PI, Gould EW, Penneys NS. Pruritic papular eruption of the acquired immunodeficiency syndrome: A clinicopathologic study. J Am Acad Dermatol. 1991;24:231–5.
17. Rosenthal D, LeBoit PE, Klumpp L, Berger TG. Human immunodeficiency virus-associated eosinophilic folliculitis. A unique dermatosis associated with advanced human immunodeficiency virus infection. Arch Dermatol. 1991;127:206–9.
18. Duvic M, Johnson TM, Rapini RP, Freese T, Brewton G, Rios A. Acquired immunodeficiency syndrome-associated psoriasis and Reiter's syndrome. Arch Dermatol. 1987;123:1622–32.
19. Vasudevan B, Sagar A, Bahal A, Brig AP, Mohanty VS. Cutaneous manifestations of HIV –A detailed study of morphological variants, markers of advanced disease, and the changing spectrum. Med J Armed Forces India. 2012;68:20–7.
20. Lanjewar DN. The spectrum of clinical and pathological manifestations of AIDS in a consecutive series of 236 autopsied cases in mumbai, India. Patholog Res Int 2011. 2011 547618.
2. Cedeno-Laurent F, Gomez-Flores M, Mendez N, Ancer-Rodriguez J, Bryant JL, Gaspari AA, et al. New insights into HIV-1-primary skin disorders. J int AIDS soc.,2011 jan 24. 14:5.
3. Coldiron BM, Bergstresser PR. Prevalence and clinical spectrum of skin disease in patients infected with human immunodeficiency virus. Arch Dermatol. 1989;125:357–61.
4. Tschachler E, Bergstresser PR, Stingl G. HIV-related skin diseases. Lancet. 1996;348:659–63.
5. Sanjay M. Chawhan, Dharitri M. Bhat, Seema M. Solanke. Dermatological manifestations in human immunodeficiency virus infected patients: Morphological spectrum with CD4 correlation. Indian J Sex Transm Dis. 2013 Jul-Dec; 34(2): 89–94. doi: 10.4103/0253-7184.120538PMCID: PMC3841677
6. Nirja Jindal, Aruna Aggarawal. HIV seropositive and HIV associated dermatosis among patients presenting with skin and mucocutaneous disorders. Indian journal of dermatology, venerology and leprology.2009;75:283-286.
7. Kumarasamy N, Vallabhaneni S, Flanigan TP, Mayer KH, Solomon S. Clinical profile of HIV in India. Indian J Med Res. 2005;121:377–94.
8. Francis N. Non-neoplastic, cutaneous and mucocutaneous manifestations of HIV infection. Histopathology. 1993;23:297–305.
9. Kaplan MH, Sadick N, McNutt NS, Meltzer M, Sarngadharan MG, Pahwa S. Dermatologic findings and manifestations of acquired immunodeficiency syndrome (AIDS) J Am Acad Dermatol. 1987;16:485–506.
10. 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.
11. Kumarasamy N, Solomon S, Madhivanan P, Ravikumar B, Thyagarajan SP, Yesudian P. Dermatologic manifestations among human immunodeficiency virus patients in south India. Int J Dermatol. 2000;39:192–5.
12.Muñoz-Pérez MA, Rodriguez-Pichardo A, Camacho F, Colmenero MA. Dermatological findings correlated with CD4 lymphocyte counts in a prospective 3 year study of 1161 patients with human immunodeficiency virus disease predominantly acquired through intravenous drug abuse. Br J Dermatol. 1998;139:33–9.
13. Nichols L, Balogh K, Silverman M. Bacterial infections in the acquired immune deficiency syndrome. Clinicopathologic correlations in a series of autopsy cases. Am J Clin Pathol. 1989;92:787–90.
14. Dover JS, Johnson RA. Cutaneous manifestations of human immunodeficiency virus infection. Part II. Arch Dermatol. 1991;127:1549–58.
15. Inserra DW, Bickley LK. Crusted scabies in acquired immunodeficiency syndrome. Int J Dermatol. 1990;29:287–9.
16. Hevia O, Jimenez-Acosta F, Ceballos PI, Gould EW, Penneys NS. Pruritic papular eruption of the acquired immunodeficiency syndrome: A clinicopathologic study. J Am Acad Dermatol. 1991;24:231–5.
17. Rosenthal D, LeBoit PE, Klumpp L, Berger TG. Human immunodeficiency virus-associated eosinophilic folliculitis. A unique dermatosis associated with advanced human immunodeficiency virus infection. Arch Dermatol. 1991;127:206–9.
18. Duvic M, Johnson TM, Rapini RP, Freese T, Brewton G, Rios A. Acquired immunodeficiency syndrome-associated psoriasis and Reiter's syndrome. Arch Dermatol. 1987;123:1622–32.
19. Vasudevan B, Sagar A, Bahal A, Brig AP, Mohanty VS. Cutaneous manifestations of HIV –A detailed study of morphological variants, markers of advanced disease, and the changing spectrum. Med J Armed Forces India. 2012;68:20–7.
20. Lanjewar DN. The spectrum of clinical and pathological manifestations of AIDS in a consecutive series of 236 autopsied cases in mumbai, India. Patholog Res Int 2011. 2011 547618.
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22-12-2017
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