Journal of the American Academy of Dermatology
Volume 54, Issue 4 , Pages 581-588 , April 2006

Cutaneous manifestations of HIV in the era of highly active antiretroviral therapy: An institutional urban clinic experience

  • Pedro C. Queiroz Zancanaro, MD

      Affiliations

    • From the Faculdade de Medicina, Universidade de Brasilia
    • These authors contributed equally to this manuscript.
    • ,
  • Laura Y. McGirt, MD

      Affiliations

    • Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore
    • These authors contributed equally to this manuscript.
    • ,
  • Adam J. Mamelak, MD

      Affiliations

    • Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore
    • ,
  • Ruby H.-N. Nguyen, PhD

      Affiliations

    • The National Institute of Environmental Health Sciences, Durham
    • ,
  • Ciro R. Martins, MD

      Affiliations

    • Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore
    • Corresponding Author InformationReprint requests: Ciro R. Martins, MD, Department of Dermatology, Johns Hopkins University, 550 N Broadway, Suite 1002, Baltimore, MD 21205.

,Accepted 15 December 2005.

References 

  1. Dover JS, Johnson RA. Cutaneous manifestations of human immunodeficiency virus infection. Part II. Arch Dermatol. 1991;127:1549–1558
  2. Dover JS, Johnson RA. Cutaneous manifestations of human immunodeficiency virus infection. Part I. Arch Dermatol. 1991;127:1383–1391
  3. Tschachler E, Bergstresser PR, Stingl G. HIV-related skin diseases. Lancet. 1996;348:659–663
  4. Goldstein B, Berman B, Sukenik E, Frankel SJ. Correlation of skin disorders with CD4 lymphocyte counts in patients with HIV/AIDS. J Am Acad Dermatol. 1997;36:262–264
  5. Jensen BL, Weismann K, Sindrup JH, Sondergaard J, Schmidt K. Incidence and prognostic significance of skin disease in patients with HIV/AIDS: a 5-year observational study. Acta Derm Venereol. 2000;80:140–143
  6. McCrossin I, Wong D. HIV-related skin disease. Med J Aust. 1993;158:179–185
  7. Garbe C, Husak R, Orfanos CE. [HIV-associated dermatoses and their prevalence in 456 HIV-infected patients. Relation to immune status and its importance as a diagnostic marker]. Hautarzt. 1994;45:623–629German
  8. Kaplan MH, Sadick N, McNutt NS, Meltzer M, Sarngadharan MG, Pahwa S. Dermatologic findings and manifestations of acquired immunodeficiency syndrome (AIDS). J Am Acad Dermatol. 1987;16:485–506
  9. Kurwa HA, Marks R. Protracted cutaneous disorders in association with low CD4+ lymphocyte counts. Br J Dermatol. 1995;133:625–629
  10. Kumarasamy N, Solomon S, Madhivanan P, Ravikumar B, Thyagarajan SP, Yesudian P. Dermatologic manifestations among human immunodeficiency virus patients in south India. Int J Dermatol. 2000;39:192–195
  11. Flexner C. HIV-protease inhibitors. N Engl J Med. 1998;338:1281–1292
  12. Aftergut K, Cockerell CJ. Update on the cutaneous manifestations of HIV infection. Clinical and pathologic features. Dermatol Clin. 1999;17:445–471vii
  13. Sabin CA. The changing clinical epidemiology of AIDS in the highly active antiretroviral therapy era. AIDS. 2002;16(Suppl 4):S61–S68
  14. Update: trends in AIDS incidence—United States, 1996. MMWR Morb Mortal Wkly Rep. 1997;46:861–867
  15. Girardi E, Palmieri F, Cingolani A, Ammassari A, Petrosillo N, Gillini L, et al. Changing clinical presentation and survival in HIV-associated tuberculosis after highly active antiretroviral therapy. J Acquir Immune Defic Syndr. 2001;26:326–331
  16. Survival after introduction of HAART in people with known duration of HIV-1 infection. The CASCADE Collaboration. Concerted Action on SeroConversion to AIDS and Death in Europe. Lancet. 2000;355:1158–1159
  17. Ives NJ, Gazzard BG, Easterbrook PJ. The changing pattern of AIDS-defining illnesses with the introduction of highly active antiretroviral therapy (HAART) in a London clinic. J Infect. 2001;42:134–139
  18. Maurer T, Rodrigues LK, Ameli N, Phanuphak N, Gange SJ, DeHovitz J, et al. The effect of highly active antiretroviral therapy on dermatologic disease in a longitudinal study of HIV type 1-infected women. Clin Infect Dis. 2004;38:579–584
  19. Calista D, Morri M, Stagno A, Boschini A. Changing morbidity of cutaneous diseases in patients with HIV after the introduction of highly active antiretroviral therapy including a protease inhibitor. Am J Clin Dermatol. 2002;3:59–62
  20. Brodt HR, Kamps BS, Gute P, Knupp B, Staszewski S, Helm EB. Changing incidence of AIDS-defining illnesses in the era of antiretroviral combination therapy. AIDS. 1997;11:1731–1738
  21. Hengge UR, Franz B, Goos M. Decline of infectious skin manifestations in the era of highly active antiretroviral therapy. AIDS. 2000;14:1069–1070
  22. Domingo P, Torres OH, Ris J, Vazquez G. Herpes zoster as an immune reconstitution disease after initiation of combination antiretroviral therapy in patients with human immunodeficiency virus type-1 infection. Am J Med. 2001;110:605–609
  23. Bilu D, Mamelak AJ, Nguyen RH, Queiroz PC, Kowalski J, Morison WL, et al. Clinical and epidemiologic characterization of photosensitivity in HIV-positive individuals. Photodermatol Photoimmunol Photomed. 2004;20:175–183
  24. Holmes RB, Martins C, Horn T. The histopathology of folliculitis in HIV-infected patients. J Cutan Pathol. 2002;29:93–95
  25. French M, Lenzo N, John M, Mallal S, Price P. Highly active antiretroviral therapy. Lancet. 1998;351:1056–1057author reply 1058-9
  26. Barkan SE, Melnick SL, Preston-Martin S, Weber K, Kalish LA, Miotti P, et al. The Women's Interagency HIV Study. WIHS Collaborative Study Group. Epidemiology. 1998;9:117–125
  27. Healy E, Meenan J, Mulcahy F, Barnes L. The spectrum of HIV related skin diseases in an Irish population. Ir Med J. 1993;86:188–190
  28. Munoz-Perez MA, Rodriguez-Pichardo A, Camacho F, Colmenero MA. Dermatological findings correlated with CD4 lymphocyte counts in a prospective 3 year study of 1161 patients with human immunodeficiency virus disease predominantly acquired through intravenous drug abuse. Br J Dermatol. 1998;139:33–39
  29. Uthayakumar S, Nandwani R, Drinkwater T, Nayagam AT, Darley CR. The prevalence of skin disease in HIV infection and its relationship to the degree of immunosuppression. Br J Dermatol. 1997;137:595–598
  30. Wiwanitkit V. Prevalence of dermatological disorders in Thai HIV-infected patients correlated with different CD4 lymphocyte count statuses: a note on 120 cases. Int J Dermatol. 2004;43:265–268
  31. Handa S, Bingham JS. Dermatological immune restoration syndrome: does it exist?. J Eur Acad Dermatol Venereol. 2001;15:430–432
  32. Milazzo F, Piconi S, Trabattoni D, Magni C, Coen M, Capetti A, et al. Intractable pruritus in HIV infection: immunologic characterization. Allergy. 1999;54:266–272
  33. Cohen AJ, Steigbigel RT. Eosinophilia in patients infected with human immunodeficiency virus. J Infect Dis. 1996;174:615–618
  34. Lucey DR, Zajac RA, Melcher GP, Butzin CA, Boswell RN. Serum IgE levels in 622 persons with human immunodeficiency virus infection: IgE elevation with marked depletion of CD4+ T-cells. AIDS Res Hum Retroviruses. 1990;6:427–429
  35. Cauda R, Tacconelli E, Tumbarello M, Morace G, De Bernardis F, Torosantucci A, et al. Role of protease inhibitors in preventing recurrent oral candidosis in patients with HIV infection: a prospective case-control study. J Acquir Immune Defic Syndr. 1999;21:20–25
  36. Price P, Mathiot N, Krueger R, Stone S, Keane NM, French MA. Immune dysfunction and immune restoration disease in HIV patients given highly active antiretroviral therapy. J Clin Virol. 2001;22:279–287
  37. French MA, Price P, Stone SF. Immune restoration disease after antiretroviral therapy. AIDS. 2004;18:1615–1627
  38. Celum CL. The interaction between herpes simplex virus and human immunodeficiency virus. Herpes. 2004;11(Suppl 1):36A–45A
  39. Albini T, Rao N. Molluscum contagiosum in an immune reconstituted AIDS patient. Br J Ophthalmol. 2003;87:1427–1428
  40. French MA, Lenzo N, John M, Mallal SA, McKinnon EJ, James IR, et al. Immune restoration disease after the treatment of immunodeficient HIV-infected patients with highly active antiretroviral therapy. HIV Med. 2000;1:107–115
  41. Smith KJ, Skelton HG, Yeager J, Ledsky R, McCarthy W, Baxter D, et al. Cutaneous findings in HIV-1-positive patients: a 42-month prospective study. Military Medical Consortium for the Advancement of Retroviral Research (MMCARR). J Am Acad Dermatol. 1994;31:746–754
  42. Stern RS. Epidemiology of skin disease in HIV infection: a cohort study of health maintenance organization members. J Invest Dermatol. 1994;102(Suppl):34S–37S
  43. Piketty C, Darragh TM, Da Costa M, Bruneval P, Heard I, Kazatchkine MD, et al. High prevalence of anal human papillomavirus infection and anal cancer precursors among HIV-infected persons in the absence of anal intercourse. Ann Intern Med. 2003;138:453–459
  44. Kreuter A, Schugt I, Hartmann M, Rasokat H, Altmeyer P, Brockmeyer NH. Dermatological diseases and signs of HIV infection. Eur J Med Res. 2002;7:57–62
  45. Mathes BM, Douglass MC. Seborrheic dermatitis in patients with acquired immunodeficiency syndrome. J Am Acad Dermatol. 1985;13:947–951
  46. Mosam A, Irusen EM, Kagoro H, Aboobaker J, Dlova N. The impact of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) on skin disease in KwaZulu-Natal, South Africa. Int J Dermatol. 2004;43:782–783
  47. Gomides MD, Berbert AL, Mantese SA, Rocha A, Ferreira MS, Borges AS. Skin diseases in patients with AIDS: study in 55 cases in Uberlandia, MG, Brazil. Rev Assoc Med Bras. 2002;48:36–41
  48. Lucas GM, Cheever LW, Chaisson RE, Moore RD. Detrimental effects of continued illicit drug use on the treatment of HIV-1 infection. J Acquir Immune Defic Syndr. 2001;27:251–259

 Funding sources: None.Conflicts of interest: None identified.

PII: S0190-9622(05)04956-X

doi: 10.1016/j.jaad.2005.12.030

Journal of the American Academy of Dermatology
Volume 54, Issue 4 , Pages 581-588 , April 2006

Article Tools

* Image Usage & Resolution