Histopathogical study of dermatological lesions in HIV reactive patients
Abstract
Background: Skin lesions are commonly encountered in HIV patients (>90%). Several skin diseases have proved to be sensitive and useful indicators of progression of HIV infection. Although these conditions may be seen in general healthy population, their occurrence in patients with acquired immunodeficiency syndrome is often atypical, more severe and explosive.
Objective: The present study was carried out to categorize the prevalence of different skin lesions in HIV positive patients, their clinical and histopathological analysis and role of skin biopsy in their diagnosis.
Materials and Methods: A total 60 known HIV positive patients with the symptomatic skin lesions were included and their histopathological and clinical correlation and biopsy were analyzed.
Results: Maximum patients were between 31 and 40 years (41.6 %). Papular lesions and dermatitis are the most common lesions seen in patients having CD4 count > 350 and viral and fungal infections are most common lesions seen in patients having CD4 count < 350. Out of 60 cases, 10 (16.6%) show features of papular lesions (including Pruritic Papular eruptions, Psoriasis, Seborrhoic dermatitis, Scaly lesion, Eosinophilic folliculitis, Lichen planus), 8(13.3%) show features of dermatitis (including Atopic Dermatitis, Ashy Dermatitis, Urticaria, hyperpigmented patch, Chronic Non-specific dermatitis), and 8 (13.3%) show features of bacterial infections (including Chanchroid, Hansen, TBVC, Folliculitis, pustular lesion, lupus vulgaris, syphilis, pyoderma gangrenosum). Histopathological examination showed high sensitivity of 88.8% and specificity of 96.0% in diagnosis of papular lesions.
Conclusions: Morphological pattern of skin lesions in HIV is often nondiagnostic. Histopathological correlation is therefore pivotal in the accurate diagnosis of many HIV induced skin diseases. The histopathological examination of such lesions helps in confirming the diagnosis as they have high sensitivity and specificity values.
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