Gamasoidosis (acariasis, avian-mite dermatitis or bird-mite dermatitis) is a challenging diagnosis that is becoming more common because of the frequent use of window air conditioners in tropical countries. These devices may serve as shelters for nests of urban birds such as pigeons. Dermatologists should become familiar with this infestation to establish the correct diagnosis and treatment.

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BackgroundStevens-Johnson syndrome and toxic epidermal necrolysis are life-threatening blistering drug reactions with high incidence of ocular sequela. The term ‘Epidermal Necrolysis’ has been recently used to better describe the full spectrum of the disease that includes Stevens-Johnson syndrome and toxic epidermal necrolysis at opposite ends, which differ by the extent of body surface area with epidermal detachment. SCORTEN is a mortality prognosis score for ‘Epidermal Necrolysis’ cases that still needed validation in acquired immunodeficiency syndrome.ObjectiveTo evaluate the SCORTEN performance in acquired immunodeficiency syndrome, and the differences in outcomes between acquired immunodeficiency syndrome and non- acquired immunodeficiency syndrome cohorts.MethodsRetrospective cohort study of AIDS and non-AIDS ‘Epidermal Necrolysis’ cases admitted to a Brazilian reference center from 1990-2014.ResultsFive deaths (16.7%) occurred as a consequence of EN in 30 AIDS patients, and seven (17.9%) in 39 non-AIDS patients, relative risk (RR) .92 (p=1.0). SCORTEN showed great performance, with an Area Under the Receiver Operating Curve (AUC) (ROC) of 0.90 with a 95% confidence interval ranging from .81 to .99. The performance of SCORTEN was better among non- AIDS patients than AIDS patients: AUC non- acquired immunodeficiency syndrome =0.99 (CI 05% 0.96-1.00), AUC acquired immunodeficiency syndrome = 0.74 (CI 95% 0.53-0.95), p=.02.Study LimitationsHeterogeneity of cases, wide variation of systemic corticosteroid doses when used.ConclusionSCORTEN is valid for the Brazilian population, including among those patients with acquired immunodeficiency syndrome, and, as such, its use is recommended for aiding treatment choice in this subgroup of patients.