title: Mucocutaneous manifestation of pediatric human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in relation to degree of immunosuppression: a study of a West African population.
abstract: BACKGROUND
  Mucocutaneous lesions occur at one point or the other during the course of human immunodeficiency virus (HIV) disease. These lesions can be the initial presenting features but could also be a pointer to the presence of immunosuppression.
  
  
  OBJECTIVE
  This study was carried out to determine the pattern of mucocutaneous manifestation in children who have human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in relation to their level of immunosuppression.
  
  
  METHODS
  One hundred children who were HIV seropositive aged 18months to 16years were evaluated for mucocutaneous lesions, and their degree of immunosuppression was also determined using total CD(4+) count or CD(4+) percentage. Another group of age and gender matched 100 HIV-negative children were also examined for mucocutaneous lesions.
  
  
  RESULTS
  The mucocutaneous manifestations were more common among the subjects compared to controls (P=0.000). The overall prevalence among the seropositive and seronegative subjects was 64% and 12% respectively. The prevalence of mucocutaneous findings in children with severe, moderate, and no immunosuppression were 93.8%, 55.2%, and 46.2%, respectively. The lesions were significantly more common among those with moderate and severe immunosuppression compared to those with no immunosuppression (P=0.000). Multiple lesions were more frequent among those with severe immunosuppression. Oral thrush was the most frequent lesion (25.6%) among the subjects followed by pruritic papular eruption (20.7%) and dermatophytosis (14.1%). Severe and atypical forms of dermatophytosis and herpes ulcer were also observed among the subjects.
  
  
  CONCLUSIONS
  This study shows that mucocutaneous lesions are common in children with HIV/AIDS and could be an early indicator of immune suppression. It is important to recognize them early in order to enhance early case detection and treatment.
authors.affiliation: Maitama District Hospital, Federal Capital Territory, Abuja, Nigeria. docdoms@yahoo.com
authors.forename: Dominic
authors.initials: D
authors.lastname: Umoru
authors.forename: Osawaru
authors.initials: O
authors.lastname: Oviawe
authors.forename: Michael
authors.initials: M
authors.lastname: Ibadin
authors.forename: Abel
authors.initials: A
authors.lastname: Onunu
authors.forename: Hendrith
authors.initials: H
authors.lastname: Esene
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000276:immunology*; D000293:Adolescent; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007108:Immune Tolerance; D007223:Infant; D008297:Male; D012871:Skin Diseases / Q000150:complications*; D012874:Skin Diseases, Infectious / Q000150:complications