Human Immunodeficiency Virus Infection and the Skin

Cockerell, Clay J.

doi:10.1001/archinte.1991.00400070073008

Cited by 35 publications

(9 citation statements)

References 41 publications

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“…Unusual clinical presentations of HSV infection in patients with HIV have been described, including unresponsive severe infection, necrotizing folliculitis, hyperkeratotic lesions and chronic ulcerative lesions. 5 , 8–10 A case of acne vulgaris‐like follicular lesions due to HSV was reported in a patient with HIV infection. 5 In 1974, Krishnamurthy 3 first described a case of viral sycosis due to MC.…”

Section: Discussionmentioning

confidence: 99%

Viral folliculitis on the face

Jang

Kim

Choi

et al. 2000

British Journal of Dermatology

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The common clinical presentations of herpes simplex virus (HSV) and molluscum contagiosum (MC) are well known to dermatologists. However, folliculitis due to these viruses is an infrequently reported entity and might be considered a sign of immunosuppression [such as infection with human immunodeficiency virus, (HIV)], especially in cases of folliculitis due to MC. The purpose of this study was to describe the clinical and histopathological characteristics of viral folliculitis due to HSV and MC. We retrospectively collected all our cases with histologically proven folliculitis due to HSV and MC between 1994 and 1999. A total of seven patients aged 7-54 years was identified. Prior to establishment of the diagnosis of folliculitis due to HSV and MC, they were treated with topical antibiotics or topical steroids, without improvement. Tentative diagnoses were bacterial folliculitis, syringoma, perifollicular fibrosis, contact dermatitis or pseudolymphoma. Biopsy of the lesions revealed multiple molluscum bodies in the follicular epithelium with sparing of the epidermis in four patients, and ballooning degeneration and intranuclear viral inclusions in the follicular epithelium in the other three. Three patients had evidence of underlying immune suppression, such as pregnancy, chronic viral hepatitis B and nasopharyngeal carcinoma. One patient had suffered from epilepsy for 4 years. Testing for HIV by enzyme-linked immunosorbent assay was negative in the four patients in whom this was performed, and T-cell subsets were normal in the three patients in whom these were quantified. In cases of molluscum folliculitis treated with simple curettage, the lesions cleared without scarring or recurrence. In cases of herpetic folliculitis, the lesions improved with antihistamines or acyclovir. MC or HSV should be considered in cases that present with folliculitis-like dermatoses but which are refractory to anti-infective and anti-inflammatory treatment.

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Section: Discussionmentioning

confidence: 99%

Viral folliculitis on the face

Jang

Kim

Choi

et al. 2000

British Journal of Dermatology

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“…Also characteristic of the chronic symptomatic phase of HIV disease is a series of relatively minor, but significant, complicating problems involving the skin (Cockerell, 1991) and mucous membranes (Scully, Laskaris, Pindborg, et al, 1991). Some of these difficulties are, in fact, low-grade opportunistic infections, the occurrence of which is early evidence of declining immunologic competency; others arise as a result of the reactivation of previous infections or the evolution of minor nutritional deficiencies.…”

Section: Chronic Symptomatic Hiv Diseasementioning

confidence: 99%

“…Some of these difficulties are, in fact, low-grade opportunistic infections, the occurrence of which is early evidence of declining immunologic competency; others arise as a result of the reactivation of previous infections or the evolution of minor nutritional deficiencies. They have in common a recognizable pattern: Most are reasonably ordinary minor clinical illnesses that happen, in HIV disease, in an unusual way (Cockerell, 1991).…”

Section: Chronic Symptomatic Hiv Diseasementioning

confidence: 99%

“…People with chronic symptomatic HIV disease, though, commonly develop a chronic, relapsing eosinophilic folliculitis that sometimes extends over large areas of the body's skin surface, producing both nocturnal itching and a kind of burning pain. This HIV-associated folliculitis does not heal with ordinary antibiotic treatment and tends to recur often and easily (Cockerell, 1991;Sindrup, Risby, & Weissman, 1987). Similarly, people with HIV-l often experience a resistant form of seborrheic dermatitis on the face (Mathes & Douglass, 1985); they commonly develop skin reactions to both overthe-counter and prescription drugs and may exhibit ordinary skin diseases (such as molluscum contagiosum) in unusual locations.…”

Section: Chronic Symptomatic Hiv Diseasementioning

confidence: 99%

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HIV Disease: Current Concepts

Keeling

1993

Jour of Counseling & Develop

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The human immunodeficiency virus (HIV) causes a chronic, progressive, immune deficiency disease, the most severe phase of which is Acquired Immune Deficiency Syndrome (AIDS). HIV is a newly characterized human retrovirus transmitted only by direct exposure to blood or blood derivatives, certain acts of sexual intercourse, or transfer from infected mother to fetus or infant. In this article the author reviews the most important current epidemiologic, clinical, and virologic information about HIV and HIV disease and provides a factual framework for understanding the issues created by the epidemic.

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“…Protean cutaneous diseases were described, including infections with opportunistic pathogens, neoplasms, and inflammatory disorders caused by dysregulation of the immune system. 4 Many of these diseases had unusual appearances and were not readily diagnosable using routine methods. Others were novel and initially noted only in HIV-infected patients, eg, bacillary angiomatosis and oral hairy leukoplakia.…”

mentioning

confidence: 99%