Background In HIV-positive individuals clinicians observe a broad range of skin conditions like xerosis, tumours, rash and drug-induced exanthema as well as common skin infections caused by bacteria, fungi and viruses. Beyond this, some reports point out a higher incidence on atopic conditions like atopic dermatitis (AD), sinusitis, asthma and laboratory findings like hypereosinophilia and Hyper IgE.
Methods Between May and November 2006, 196 patients of the HIV outpatient department of the Clinic for Dermatology, Venerology and Allergology at the Ruhr University Bochum underwent a dermatological examination. Skin conditions focusing on AD were measured by SCORAD (SCORing Atopic Dermatitis) and Erlanger atopy score.
Results In general, 36 patients (18.4%) out of 196 participants suffered from clinically from AD. Median count at “Erlanger Atopy Score” was 12.8 (median 11.5). Verification by SCORAD showed 55.6% (20/36) with mild, 36.1% (13/36) with moderate and 8.3% (3/36) with severe AD. Neither with pruritus and viral load nor with CDC Category a correlation was found. Exclusively CD4 counts were negative correlated with higher Visual analogue scale for prutitus (p = 0.0306). Xerosis was diagnosed in more than 53.6% of the 196 patients and thus was the leading diagnosis, although there was no correlation with the CD4 count, viral load or CDC Category. Furthermore, a negative correlation was found (p = 0.0214) between IgE and CD4 and a p-value of 0.0111 between IgE and the CDC Category (higher IgE, higher CDC Category) was demonstrated as well.
Conclusion In our sample xerosis cutis was the leading diagnosis. Furthermore, compared to pre-existing literature for the first time standardised diagnostic tools for AD, the SCORAD and the Erlanger Atopy Score, were used to examine HIV-positive individuals. Diagnostic tools help to identify the origin of dry skin in HIV-infected patients and to initiate adequate treatment.
- atopic dermatitis