Background: The presence of dermatoses is very common in Acquired Human Immunodeficiency Syndrome (AIDS). The present study was undertaken to correlate the various dermatoses with the evolutionary phases of AIDS.
Methods: We examined 223 HIV-infected patients older than 13 seen at the University of São Paulo, Faculty of Medicine of Ribeirão Preto, from 1989 to 1993. Patients were divided according to the CDC classification and assigned to groups I, II and III (initial stages of AIDS) and to group IV (fully symptomatic stage of AIDS).
Results: The mean frequency of dermatoses detected in patients with AIDS was higher compared to the early phases of HIV infection. The most frequently detected dermatoses were, in decreasing order of occurrence, dermatoses of fungal etiology, and desquamating disorders, such as psoriasis, seborrheic dermatitis, xerosis, and viral dermatoses.
Conclusions: A careful examination of skin and mucosae may be highly useful for the diagnosis of HIV infection. The number of dermatoses tended to increase during the more advanced stages of infection.
PIP: The frequency of dermatologic disorders--a common symptom in HIV-infected men and women--was investigated in 223 HIV-positive patients at various stages of disease recruited from the University of Sao Paulo, Faculty of Medicine, in Ribeirao Preto, Brazil, in 1989-93. Of these 223 patients, 152 had full-blown AIDS and the remaining 71 were asymptomatic. A total of 488 dermatoses were diagnosed. The mean number of diagnoses was 2.45 in AIDS patients and 1.61 in the asymptomatic groups. Seborrheic dermatitis, more extensive and of more abrupt onset than that observed in the general population, was the most frequent disorder, affecting 24% of patients in the initial stages of HIV and 30.3% of those with AIDS. The prevalence of viral dermatoses--primarily herpes simplex--was equivalent in both AIDS and asymptomatic patients (14.5% and 14.8%, respectively). Disorders of bacterial etiology--primarily impetigo, ecthyma, and sexually transmitted diseases--were more common in asymptomatic (16.5%) than AIDS patients (3.8%), while fungal dermatoses--predominantly oral moniliasis and tineas--were more frequent in AIDS patients (32.4%) than asymptomatic patients (22.6%). These findings suggest that careful examination of skin and mucosa may be useful for the diagnosis of HIV infection.