[Skin diseases in patients with AIDS: study in 55 cases in Uberlândia, MG, Brazil].
ABSTRACT Fifty-five patients with acquired immunodeficiency syndrome (AIDS) seen at the Dermatology outpatient clinic and who had mucocutaneous diseases were studied. These diseases, some of them opportunistic, are common but difficult to diagnose given the atypical features of the lesions.
The aim of this study was to analyse the frequency and clinical presentation of dermatoses related to Aids seen at the Dermatology outpatient clinic.
Fifty-five patients with Aids and mucocutaneous lesions were examined from 1995 to 1997 in a cross-sectional study carried out at the Dermatology outpatient clinic of the Universidade Federal de Uberlândia (Minas Gerais, Brazil). Biopsies and cultures were undertaken for laboratory diagnosis.
One hundred sixteen dermatoses were diagnosed. Fungal infections (78%) were the commonest among them, followed by viral infections (40%), papulosquamous disorders (27%), papular eruptions (18%), adverse drug reactions (10%), tumors (9%) and a variety of others (7%). The majority of the patients (67%) had more than one type of skin disorder.
In agreement with previous literature data fungal and viral infections were confirmed as the most frequent skin disorders in HIV-positive patients. Dermatological examination, laboratory tests and skin biopsy for histopathological study are necessary for appropriate diagnostic investigation of HIV-related mucocutaneous diseases considering that atypical presentation occurs in a large proportion of the patients.
- SourceAvailable from: Laura P Rocha[show abstract] [hide abstract]
ABSTRACT: Acquired immunodeficiency syndrome (AIDS) is characterized by decreased immunity, making a patient more susceptible to opportunistic infections which can have cutaneous manifestations. The aim of this study was to evaluate the local immunity of the skin through morphological and immunohistochemical analysis. Skin samples of 52 women, 27 without AIDS and 25 with AIDS, autopsied in an academic referral hospital in Brazil were evaluated. The autopsy reports and medical records were reviewed, and histochemical Hematoxylin-eosin, Picrosirius red, and Verhoeff stains as well as morphometric (Image J and KS-300 Kontron-Zeiss) and immunohistochemical (S-100 and anti-IgA) analyses of the skin were performed. Women with AIDS presented a thinner epidermis than women without AIDS (33.33 [12.00-317.66] vs 67.42 [12.00-530.02] μm; p < 0.001), with a lower number of epithelial cell layers (4.00 [2.00-11.00] vs 4.00 [2.00-16.00]; p < 0.001), a smaller cell diameter (12.92 [6.00-28.87] vs 24.32 [6.00-33.12] μm; p < 0.001), and a lower number of Langerhans cells (LC) (12.58 [0.00-81.74] vs 31.44 [0.00-169.77] LC/mm(2); p < 0.001). The dermis contained more collagen fibers (8.20 % [2.40-19.40] vs 6.30 % [0.40-13.90]; p < 0.001). Some of these parameters were negatively correlated with viral load and positively correlated with the number of CD4+ T-lymphocytes. We conclude that a decrease of the local skin immunity in women with AIDS may contribute to the development of skin lesions.Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin 08/2012; 461(4):449-55. · 2.68 Impact Factor