title: Histopathological study of cutaneous manifestations in HIV and AIDS patients.
abstract: OBJECTIVE
  Most human immunodeficiency virus (HIV)-infected patients develop various skin diseases. These skin manifestations not only act as markers but also reflect the patient's underlying immune status. Investigating CD4 counts is costly and not always possible. Thus, the potential value to be gained by using skin manifestations as predictors of low CD4 counts and disease progression should be explored. The present study attempted to correlate the association of various cutaneous disorders found in HIV patients with CD4 and CD8 counts, the CD4 : CD8 ratio and stage of HIV infection.
  
  
  METHODS
  This was a prospective study involving 61 patients who were HIV-positive and demonstrated skin lesions. Punch biopsies of skin were taken for histopathological diagnosis. CD4 and CD8 T cell counts were performed.
  
  
  RESULTS
  The study sample included a majority of male patients, most of whom were aged 21-40 years. Pruritic papular dermatitis was the most common skin manifestation, followed by molluscum contagiosum, eosinophilic folliculitis, and Hansen's disease. Most of the lesions were associated with CD4 counts of <220/μl (n = 38). All skin lesions associated with HIV or acquired immune deficiency syndrome (AIDS) showed a CD4 : CD8 ratio of <0.50.
  
  
  CONCLUSIONS
  The study findings demonstrate an inverse relationship between CD4 counts and the occurrence of skin lesions. The majority of lesions were associated with stage 3 or stage 4 infection. Thus, specific cutaneous manifestations can be considered as good clinical indicators for predicting underlying immune status in resource-poor countries.
authors: Department of Pathology, Byramjee Jeejeebhoy Government Medical College, Sassoon General Hospital, Pune, India.
authors: Sharada R
authors: SR
authors: Rane
authors: Preeti B
authors: PB
authors: Agrawal
authors: Nalini V
authors: NV
authors: Kadgi
authors: Meenal V
authors: MV
authors: Jadhav
authors: Shaila C
authors: SC
authors: Puranik
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000175:diagnosis / Q000276:immunology; D000328:Adult; D001707:Biopsy, Needle; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D003906:Developing Countries; D004802:Eosinophilia / Q000150:complications / Q000276:immunology / Q000473:pathology*; D005260:Female; D005499:Folliculitis / Q000150:complications / Q000276:immunology / Q000473:pathology*; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D008976:Molluscum Contagiosum / Q000150:complications / Q000276:immunology / Q000473:pathology*; D009894:Opportunistic Infections / Q000150:complications / Q000276:immunology / Q000473:pathology*; D011446:Prospective Studies; D011537:Pruritus / Q000150:complications / Q000276:immunology / Q000473:pathology; D012720:Severity of Illness Index; D012871:Skin Diseases / Q000150:complications / Q000276:immunology / Q000473:pathology*; D012872:Skin Diseases, Vesiculobullous / Q000150:complications / Q000276:immunology / Q000473:pathology*; D055815:Young Adult