title: Cutaneous manifestations of HIV-a detailed study of morphological variants, markers of advanced disease, and the changing spectrum.
abstract: BACKGROUND
  Cutaneous manifestations are early and easily identifiable markers of human immunodeficiency virus (HIV) infection. They can help in predicting severity and progress of the disease and can be correlated well with CD4 counts. This study was undertaken to study the cutaneous manifestations of HIV infection and to correlate them with CD4 counts. It also aimed to study the changing spectrum of these manifestations and describe cutaneous manifestations seen in advanced disease.
  
  
  METHODS
  A total of 234 HIV-positive patients not on anti-retroviral therapy, who attended the outpatient department or were admitted as inpatients at Military Hospital, Shillong during the period between May 2008 and October 2009 were included. Cutaneous, mucosal, and genitourinary manifestations in these patients were studied in detail and were correlated with CD4 counts.
  
  
  RESULTS
  Infections were the most common group of mucocutaneous manifestations, while onychomycosis was the commonly observed individual manifestation. A different set of cutaneous markers for advanced HIV disease was observed and new parameters for therapy were also arrived at.
  
  
  CONCLUSIONS
  Specific morphological variants of cutaneous markers may provide a better clue to early diagnosis of HIV and can help in diagnosing advanced stages of the disease. Fresh cutaneous markers are required for indicating cut-off levels of CD4 count at 350/μL for starting therapy.
authors.affiliation: Classified Specialist (Dermatology), Command Hospital (SC), Pune - 40.
authors.forename: Biju
authors.initials: B
authors.lastname: Vasudevan
authors.affiliation: Associate Professor, Department of Medicine, AFMC, Pune - 40.
authors.forename: Amitabh
authors.initials: A
authors.lastname: Sagar
authors.affiliation: Classified Specialist (Pathology), Military Hospital, Secunderabad.
authors.forename: Ashish
authors.initials: A
authors.lastname: Bahal
authors.affiliation: Commandant, Military Hospital, Shillong.
authors.forename: Ap
authors.initials: A
authors.lastname: Mohanty
keywords: AIDS; CD4 count; HIV; cutaneous manifestations