Mucocutaneous manifestations of HIV infection

Human immunodeficiency virus (HIV) infection is associated with several mucocutaneous conditions which may be the first clinical presentation of HIV. A wide range of infectious and non-infectious skin lesions develop during the course of the disease but their frequency and associated factors vary from place to place.

To evaluate cutaneous manifestations in HIV infected patients attending to Dermatology outpatient department and their relationship with CD4 cell counts.

It is a hospital-based cross-sectional study. One hundred and twenty HIV seropositive patients attending the outpatient and inpatient departments were included in the study. Detailed history including age, sex, occupation, presenting complaint, highrisk behaviour, mode of transmission, marital status, partner's HIV status and treatment history was taken. Thorough cutaneous and systemic examination was done in all patients. Cluster of differentiation (CD4) count was noted in all patients at the time of presentation.

Majority of the patients 85 (70.8%) were rural residents who belonged to low socio-economic and low educational strata. Housewives formed the largest group 44 (36.7%) followed by truck drivers 31 (25.8%) and laborers 25 (20.8%). The predominant mode of transmission was heterosexual contact 113 (94.2%). Most common mucocutaneous manifestations noticed were seborrheic dermatitis 78 (65%) followed by oral candidiasis 56 (46.6%), xerosis 51 (42.5%), generalized skin hyperpigmentation 42 (35%) and dermatophytosis 40 (33.3%).

This study showed the prevalence of various dermatological manifestations in HIV positive patients and their relation with CD4 count. Most of the manifestations occur in patients with low CD4+ count (<200). Early recognition of mucocutaneous manifestations helps in the early diagnosis and better management of the disease.