Amita Singh

Dermatological manifestations in HIV-infected patients at a tertiary care hospital in a tribal (Bastar) region of Chhattisgarh, India

Background: Cutaneous disorders during HIV infection are numerous and skin is often the first and only organ affected during most of the course of HIV disease. Some Cutaneous disorders reflect the progression of HIV disease; though the relation is still controversial. Aims: The objective of this study, conducted at a tertiary care centre in Bastar, Jagdalpur, is to estimate the status of cutaneous manifestation in HIV-infected patients and its relationship with CD4 cell counts. Methods: We enrolled 137 HIV positive subjects. Demographic information such as age, gender, weight, height, socioeconomic status, and educational status were recorded. Laboratory parameter (CD4 counts) and treatment regimen were noted. Patients were examined for skin disorders by a dermatologist. Data were analyzed using chi-square test for categorical variables. Results: Majority of the patients were from rural area (65.69%) and belonged to a low socioeconomic and educational status. 30.65% of the patients were housewives, 23.35% drivers, and 16.78% labourers. Predominant mode of transmission was heterosexual contact (94.16%). Most common HIV-related dermatological manifestations were seborrheic dermatitis (74.16%), xerosis (52.5%), generalized skin hyperpigmentation 56 (46.67%), onychomycosis 53 (44.16%), pruritic papular eruption 27 (22.5%), oral candidiasis 21 (17.5%), photo dermatitis 21 (17.5%), and scabies 4 (3.33%). Significant correlation with low CD4+ cell counts was found for oral candidiasis (P < 0.0001) and Kaposis sarcoma (P = 0.03), while other disorders such as seborrheic dermatitis (P = 0.22), xerosis (P = 0.25), and onychomycosis (P = 0.08) were not statistically significant. Conclusion: This study showed high prevalence of dermatological manifestations in HIV-infected subjects, and they occur more frequently with progression of HIV and decline in immune functions. Therefore, early diagnosis and management of skin disorders can improve the quality of life of HIV-infected subjects.

HIV-infected patients and dermatological manifestations in a tertiary care hospital in the tribal (Bastar) region of Chhattisgarh, India between January 2006 and June 2008

Objective: The aim of this study is to estimate the status of cutaneous manifestations in HIV-infected patients and its co-relationship with the CD4 cell count at a tertiary care centre at Bastar, Jagdalpur. Material and Methods: In this study, 137 HIV-positive subjects were enrolled. Information on demographics i.e. weight, height, socioeconomic status, age, educational status, sex, laboratory parameters (CD4 counts) and treatment regimens were noted, and patients were examined for skin disorders by a dermatologist. Data were analyzed using Chi-square test for categorical variables. Results: Majority of the patients resided in a rural area (65.69%), and belonged to low socioeconomic and educational status; 30.65% were housewives, 23.35% drivers and 16.78% laborers respectively. The predominant mode of transmission was heterosexual contact (94.16%). The most common HIV-related dermatological manifestations were seborrheic dermatitis (74.16%), xerosis (52.5%), generalized skin hyperpigmentation 56 (46.67%), onychomycosis 53 (44.16%), pruritic papular eruption 27 (22.5%), oral candidiasis 21 (17.5%), photo dermatitis 21 (17.5%) and scabies 4 (3.33%). Significant correlation with low CD4+ cell counts was found for oral candidiasis ( P P 0.03), while other disorders like seborrheic dermatitis ( P 0.22), xerosis ( P 0.25) and onychomycosis ( P 0.08) were not statistically significant. Conclusion: This study showed a high prevalence of dermatological manifestations in HIV-infected subjects, and they occur more frequently with progression of HIV and decline in immune functions. So, early diagnosis and management of skin disorders can improve the quality of life of HIV-infected subjects.