a cross-sectional study of dermatological manifestations in children with human immunodeficiency virus/acquired immunodeficiency syndrome

Abstract

Background: In children, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is a significant cause of acquired immunodeficiency in children. HIV/AIDS is associated with change in the clinical presentation of the opportunistic infections and increased likelihood of development of certain inflammatory dermatoses in children. Aims and Objectives: The primary objective of this study was to study dermatological manifestations in children with HIV/AIDS. The secondary objectives were to study the association of dermatological manifestation with degree of immunosuppression and any clinical alteration in the disease presentation. Materials and Methods: This was a cross-sectional, descriptive study carried out in the setting of a state government hospital with an attached antiretroviral therapy referral center. The duration of the study was 30 months, and the sample size was based on children enrolled in the study during this duration. Inclusion Criteria: Children <15 years of age having HIV/AIDS and any cutaneous manifestation associated with HIV/AIDS were included in the study. Exclusion Criteria: Dermatological manifestations in children with inherited cause of immunodeficiency, drug-induced immunosuppression, and juvenile diabetes mellitus were excluded from the study. Results: Recurrent skin and soft-tissue infections in 26.11% (n = 11) were the most common dermatological manifestation, followed by pruritic papular eruption of HIV (n = 7, 16.66%), herpes zoster (n = 6, 14.28%), seborrheic dermatitis (n = 4, 9.52%), and human papillomavirus infections (n = 4, 9.52%), which were other common manifestations. The mean CD4 count of patients with pruritic papular eruption was 517 cells/cm3. Extrapulmonary tuberculosis was the most common form in 66.66% (n = 8) of children of total 12 children with tuberculosis. Conclusion: Pruritic papular eruption of HIV in children is seen at all ranges of CD4 count and does not correlate or suggest an advanced degree of immunosuppression. Older children aged 10–14 years acquired HIV through high-risk sexual behavior which suggests a need of sex education.