Mucocutaneous manifestations in children with HIV infection and AIDS.

Abstract

Mucocutaneous diseases are more frequent in HIV/AIDS-infected children than in the normal population. We analyze mucocutaneous disorders with atypical presentations in a large population of HIV-infected children, with or without full-blown AIDS, compared to a population of HIV seroreverted children. The majority of these cutaneous disorders have an infectious etiology and their frequency is related to the degree of deterioration of the immune system. Some diseases commonly observed in adults are rare in children; neoplasms are an exception.

Mucocutaneous manifestations in children with human immunodeficiency virus infection

“…Warts can be single but usually are multiple. [15,28,30] Extensive anogenital warts, very resistant to treatment, have also been observed. [43] Epidermodysplasia verruciformis, an HPV infection caused by HPV types 5 and 8, is an autosomal recessive disorder and has been known to occur in association with many immunodeficient states including HIV.…”

“…[43] Epidermodysplasia verruciformis, an HPV infection caused by HPV types 5 and 8, is an autosomal recessive disorder and has been known to occur in association with many immunodeficient states including HIV. [44] Molluscum contagiosum: In children with HIV infection, it often involves atypical areas, such as the face and neck [15,34] and tend to be more confluent and occasionally extremely numerous. [15,36,42] In addition, giant lesions (>1 cm) may occur.…”

“…[14] CUTANEOUS MANIFESTATIONS Skin is commonly involved in HIV infection and nearly 90% of patients with HIV infection have dermatological manifestations at some stage during the course of their disease. [15,16] The data currently with regard to the mucocutaneous manifestations of HIV infection in pediatric population come mainly from the western literature. The prevalence of mucocutaneous manifestations in children with HIV infection, from various parts of the world, is highly variable, ranging from as low as 42% to almost 93%.…”

“…[24] INFECTIONS Fungal infections Candidiasis: Candidiasis is one of the most common mucocutaneous manifestations of HIV infection in children, and its incidence has been estimated to range between 20% to 72%. [15,17,25,26] Oral involvement is the most common [ Figure 1a] presentation of which can be as: (1) pseudomembranous (thrush), (2) erythematous (atrophic), (3) papillary hyperplasia, (4) chronic hyperplastic, (5) angular cheilitis, and (6) median rhomboid glossitis. It has been suggested in several studies that thrush is a marker of rapid HIV disease progression and death.…”

“…Tinea corporis, tinea capitis, tinea faciale, and onychomycosis [ Figure 1b] are particularly common. [15,30] Cases of severe (such as kerion) and recurrent tinea capitis have been observed. [28] Proximal white subungual onychomycosis of fingernails, periungual involvement, and rapid spreading of the infection to involve all 10 finger and toenails are common findings in HIV-infected individuals with low CD 4 cell counts.…”