title: Skin conditions in a South African tuberculosis hospital: Prevalence, description, and possible associations.
abstract: BACKGROUND
  The current pandemic of tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection, the modern era of antiretroviral therapy, and the rising incidence of multidrug-resistant TB have led to a broader spectrum of skin conditions in patients hospitalized with TB. These factors also influence investigations into possible causal relationships with TB.
  
  
  OBJECTIVE
  The aim of this study was to describe mucocutaneous conditions found in patients hospitalized with TB and to report associated factors.
  
  
  METHODS
  A cross-sectional observational study examining the spectrum of skin manifestations found in 105 patients hospitalized with TB was conducted. All relevant demographic and clinical data were collected. Possible associations were evaluated by making use of statistical analysis.
  
  
  RESULTS
  Seventy-four (70%) of the investigated population were HIV-positive, and 46 (44%) patients were being treated for drug-resistant TB. The most prevalent dermatosis was xerosis (n = 83, 79%), followed by oral candidiasis (n = 33, 31%) and scars (n = 33, 31%), finger clubbing (n = 31, 29%), leukonychia (n = 29, 28%), striae (n = 25, 24%), and facial hyperpigmentation (n = 22, 21%). Anemia was detected in 90 (86%) patients, and 75 (71%) were classified as being underweight. Three patients were diagnosed with cutaneous TB.
  
  
  CONCLUSIONS
  Patients hospitalized with TB have on average four different dermatoses, but xerosis remains the leading dermatological finding, irrespective of HIV status or TB drug sensitivity. Anemia and malnutrition are associated with numerous skin conditions found in this population. The prevalence of cutaneous TB among patients hospitalized with TB remains low, despite the high rate of TB and HIV co-infection.
authors.affiliation: Division of Dermatology, Department of Medicine, University of Stellenbosch and Tygerberg Academic Hospital, Tygerberg, Cape Town, South Africa. mclachlanirene@gmail.com.
authors.forename: Iréne
authors.initials: I
authors.lastname: McLachlan
authors.affiliation: Division of Dermatology, Department of Medicine, University of Stellenbosch and Tygerberg Academic Hospital, Tygerberg, Cape Town, South Africa.
authors.forename: Willem I
authors.initials: WI
authors.lastname: Visser
authors.affiliation: Division of Dermatology, Department of Medicine, University of Stellenbosch and Tygerberg Academic Hospital, Tygerberg, Cape Town, South Africa.
authors.forename: H Francois
authors.initials: HF
authors.lastname: Jordaan
mesh_terms: D000328:Adult; D000740:Anemia / Q000453:epidemiology; D002180:Candidiasis, Oral / Q000453:epidemiology*; D002921:Cicatrix / Q000453:epidemiology*; D060085:Coinfection / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006679:HIV Seropositivity / Q000150:complications / Q000453:epidemiology*; D006763:Hospitals, Chronic Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D010005:Osteoarthropathy, Secondary Hypertrophic / Q000453:epidemiology; D015995:Prevalence; D012871:Skin Diseases / Q000453:epidemiology*; D013019:South Africa / Q000453:epidemiology; D013851:Thinness / Q000453:epidemiology; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D014382:Tuberculosis, Cutaneous / Q000453:epidemiology; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology