European Journal of Molecular & Clinical Medicine

Abstract

Background: With the progression of the HIV epidemic there is a need to classify the papulonodular eruptions of the HIV infection based on its likely aetiology for proper management of HIV. This study was aimed to study the clinical and pathological aspects of papulonodular lesions of skin in HIV infected individuals.
Methods: The study was conducted among all Human Immunodeficiency Virus (HIV) infected patients who presented with papular and nodular skin lesions at the outpatient’s department as well as those admitted in a tertiary care government hospital. Each patient underwent a detailed history taking which included chief complaints, treatment history, and personal history. Dermatological examination included morphology of lesion, site, number, size, shape, colour, margin and surface of skin lesions. Skin biopsy was performed on all the cases and specimen sent to Department of Pathology for histopathology report to correlate the clinical and histopathological diagnoses.
Results: A total of 55 cases were studied. 48 (87.27%) cases were males and 7 (12.73%) cases were females. The age ranged from 25-48years (mean age-34.90 years) for males and 26-46 years (mean age- 36 years) in females. Of the total 55 cases, 18 (32.73%) cases had infective dermatoses and the remaining 37 (67.27%) had non-infective dermatoses. Pruritic papular eruption formed the majority of the cases 20 (54.05%), 15 of them had a low CD4 count <200/µL (Mean CD4 count was (126/µL). All patients showed good response to HAART. Eosinophilic folliculitis was found in 4 cases with 3 cases having CD4 count <200/µL (mean 72/µL).
Conclusion: Patients with infective and non-infective cutaneous manifestations are significantly immuno-suppressed than HIV-positive asymptomatic controls. The absolute CD4 count is inversely related to the number of HIV positive patients with papulonodular eruptions of skin. Hence, there is a need for histopathology examination to separate these closely related entities for precise diagnosis and proper management in HIV patients