Bullous impetigo in homosexual men--a risk marker for HIV-1 infection?

OBJECTIVE

To determine the incidence of bullous impetigo in a group of homosexual men at high risk of HIV-1 infection.

DESIGN

A longitudinal descriptive study (1984-9).

SETTING

A private primary care and STD clinic in Sydney, Australia.

SUBJECTS

88 homosexual men documented to seroconvert to HIV-1, and 37 homosexual controls who had practised unprotected anal intercourse with another man known to be HIV-1 positive but who remained HIV-1 negative.

MAIN OUTCOME MEASURE

Incidence of bullous impetigo.

RESULTS

The crude annual incidence of bullous impetigo was 0.015 in subjects while they remained HIV-1 negative (10 cases) and 0.045 in early HIV-1 positive subjects (2 cases). Overall, 9% of the HIV-1 seroconverters and 9% of the HIV-1 negative controls were documented as suffering bullous impetigo over a mean of 29.2 and 39.3 months, respectively.

CONCLUSIONS

Bullous impetigo in an adult could prove to be a clinical indication that a person is either infected with HIV-1 or is in close (possibly sexual) contact with a person with HIV-1 infection. If true, the recognition of bullous impetigo could provide an opportunity for behavioural intervention to limit the spread of HIV-1.