Singh A, Thappa D M, Hamide A
Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.
J Dermatol. 1999 May;26(5):294-304. doi: 10.1111/j.1346-8138.1999.tb03475.x.
Third world countries, including India, lack sophisticated investigations to assess the progression of HIV disease. Hence, this study was undertaken to determine the clinical mucocutaneous markers of HIV disease and to establish its relationship with the stage of the disease. This was an observational institutional study of 75 patients with mucocutaneous disorders and HIV infection recruited over a period extending from September of 1996 to June of 1998. The patients with mucocutaneous lesions were staged according to the Centers for Disease Control classification system for HIV infection (1986). The most frequent mode of acquisition of HIV infection was heterosexual contact (96%). The patients were broadly categorized into two groups. The AIDS group was comprised of patients who were in group IV and the early HIV infection group included patients in group II and III; none were detected in group I. Forty-eight cases belonged to the AIDS group, and 27 belonged to the early HIV infection group. A total of 207 dermatoses were diagnosed and grouped as fungal, viral, bacterial, or miscellaneous. The common mucocutaneous disorders in order of frequency observed in this study were: candidiasis, dermatophytosis, herpes simplex, oral aphthae, xerosis/ichthyosis, scabies, HPV infection, molluscum contagiosum, and psoriasis. Xerosis/acquired ichthyosis and giant molluscum contagiosum were characteristically seen in group IV of HIV disease, whereas oral candidiasis, oral aphthae, papular dermatitis of HIV, and psoriasis were early warning signs. The mean number of dermatoses per patient in group IV was 3.15; in group III, it was 2.41; and in group II, it was 1.5. There was a statistically significant difference between the early HIV infection group and AIDS group with regard to number of dermatoses. Apart from syphilis and human papilloma virus infection, the treatment outcomes were satisfactory.
包括印度在内的第三世界国家缺乏评估艾滋病病情进展的精密检查手段。因此，开展本研究以确定艾滋病的临床皮肤黏膜标志物，并确立其与疾病阶段的关系。这是一项对1996年9月至1998年6月期间招募的75例患有皮肤黏膜疾病且感染了艾滋病病毒的患者进行的观察性机构研究。患有皮肤黏膜病变的患者根据美国疾病控制中心的艾滋病病毒感染分类系统（1986年）进行分期。感染艾滋病病毒最常见的途径是异性接触（96%）。患者大致分为两组。艾滋病组由处于IV期的患者组成，早期艾滋病病毒感染组包括处于II期和III期的患者；I期未检测到患者。48例属于艾滋病组，27例属于早期艾滋病病毒感染组。共诊断出207种皮肤病，并分为真菌性、病毒性、细菌性或其他类。本研究中按观察到的频率排序的常见皮肤黏膜疾病为：念珠菌病、皮肤癣菌病、单纯疱疹、口腔溃疡、皮肤干燥/鱼鳞病、疥疮、人乳头瘤病毒感染、传染性软疣和银屑病。皮肤干燥/获得性鱼鳞病和巨大传染性软疣在艾滋病病情IV期有特征性表现，而口腔念珠菌病、口腔溃疡、艾滋病丘疹性皮炎和银屑病是早期警示信号。IV期患者每人皮肤病的平均数量为3.15种；III期为2.41种；II期为1.5种。早期艾滋病病毒感染组和艾滋病组在皮肤病数量方面存在统计学上的显著差异。除梅毒和人乳头瘤病毒感染外，治疗效果令人满意。
