Nail pigmentation and fatigue

Advances in Infectious Diseases, 2011

Purposes. This study examined whether melanonychia was more prevalent in 1) HIV positive individuals compared to HIV negative persons, 2) HIV positives exposed to zidovudine and/or stavudine and 3) those with darker skin pigmentation. Procedures. 267 HIV positive and 273 HIV negative patients were examined for presence or absence of melanonychia and level of skin pigmentation using the Fitzgerald scale. Pharmacy records were examined for determining exposure to zidovudine or stavudine. Chi square, odds ratios and logistic regression were used to examine the study questions Main Findings. Melanonychia appeared in 49.1% of 267 HIV positive and 21.8% of 273 HIV negative subjects. Adjusting for skin pigmentation, HIV positives were 4.1 times more likely to have melanonychia than HIV negatives. Melanonychia was present in 54% of those receiving zidovudine and in 42% of those receiving stavudine (OR = 2.73, p = 0.05). In a multivariate model in HIV positives which included skin type, prescription of zidovudine and/or Stavudine, only dark skin (OR = 14.62, p < 0.001) and zidovudine (OR = 2.65, p < 0.03) were significant. Principal Conclusions. HIV infected persons are prone to melanonychia. This is more frequent in darker skinned persons and is enhanced in those exposed to zidovudine.

Journal of the American Academy of Dermatology, 1996

Journal of the American Academy of Dermatology, 2000

Journal of Enam Medical College, 2019

Human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/ AIDS) is a global pandemic. According to Global HIV & AIDS statistics 2018, approximately 36.9 million people are living with HIV globally, 77.3 million [59.9 million–100 million] people have become infected with HIV since the start of the epidemic, 35.4 million [25.0–49.9 million] people died from AIDS-related illnesses since the start of the epidemic and 940000 [670000–1.3 million] people died from AIDS-related illnesses in 2017. It weakens a person’s immune system by destroying important cells that fight disease and infection. Dermatologic diseases are common in the HIV-infected population. Skin disease can be uniquely associated with HIV disease and many of the cutaneous diseases are not unique to this group, but the presentation can be more severe and recalcitrant to treatment. The spectrum of skin conditions includes skin findings associated with primary HIV infection and a broad range of skin...

Annals of Tropical Medicine and Public Health, 2013

Human immunode iciency virus (HIV) infection has caused a severe degree of morbidity and mortality amongst the individuals worldwide. Those affected usually belong to low socioeconomic status especially from developing countries like India. There are numerous diagnostic criteria and thousands of tests to detect HIV positivity. One such criterion is European Commission Clearinghouse, wherein HIV positivity may be detected by thorough clinical observation of the oral cavity. This criterion is being followed worldwide and has been proven to be effective for dental professionals and general physicians, as it is stated that these oral lesions precede the other lesions of HIV positivity. We report one such case of unusual combination of melanotic hyperpigmentation and nonspeci ic ulcer in an adult patient, where HIV positivity was con irmed later by Western blot. To our knowledge, none such case has been reported in literature previously.

Journal of Evolution of medical and Dental Sciences, 2015

BACKGROUND In today's era of HIV pandemic, it is vital for the physician and the dermatologist to be aware of the wide spectrum of cutaneous manifestations of HIV, as they could be one of the earliest indicators of retroviral illness warranting a prompt diagnosis and early initiation of antiretro viral therapy. AIMS To study the mucocutaneous manifestations of HIV and correlate it with CD4 counts. SETTINGS AND DESIGN All the HIV positive patients referred from an HIV physician to a dermatologist for screening of mucocutaneous manifestations of HIV were included for a period of 6 months. MATERIALS AND METHOD The anonymised records of 36 patients were accessed for relevant demographical and dermatological data including details of ART and the CD4 counts within the last 6 months. STATISTICAL ANALYSIS USED The data was collated on Microsoft Excel 2010 and was analysed using SPSS version 21. Descriptive statistics included frequencies, proportions and Chi sq. test. RESULTS There were 24 males (66.7%) and 12 females (33.3%). The mean CD4 counts were 237cells/mm 3. The common mucocutaneous manifestations of HIV were oral candidiasis (58.3%), seborrhoeic dermatitis (30.6%), generalised xerosis (25%), longitudinal melanonychia and dermatophytosis (16.7%), bacterial infections and brittle nails (13.9%) and onychomycosis (11.1%). The other less common manifestations were pruritic papular eruptions of HIV (8.3%), koilonychia, paronychia, lichen planus, acquired ichthyosis and shiny nails (5.6%). Oral candidiasis was noted to be more common in men than in women. The CD4 counts decreased as the HIV clinical staging increased. CONCLUSIONS Certain dermatoses tend to occur more commonly in an HIV infected patient. The mucocutaneous manifestations of HIV often correlate with the CD4 counts and in a resource limited health setup help to judge the immune status of an HIV patient, prompting early initiation of ART which decrease morbidity and mortality and improve the quality of life of these patients.

Serbian Journal of Dermatology and Venerology, 2011

The authors present a case of a man with urticaria pigmentosa and acquired immunodeficiency syndrome - AIDS. The patient was diagnosed as HIV (human immunodeficiency virus) - positive in the year 2000, at the Infectious Diseases Clinic, Clinical Center of Vojvodina in Novi Sad. Urticaria pigmentosa was detected (nine years later) during a dermatological examination at the Dermatovenerology Department of the Outpatient Clinic, Clinical Center of Vojvodina. Urticaria pigmentosa is the most common manifestation of cutaneous mastocytosis. The patient was taking long term antiviral therapy for several years. Approximately 2 years after the onset of urticaria pigmentosa, this patient developed septicemia and ascites along with hepatosplenomegaly, liver damage, chronic cholecystitis, leukopenia, thrombocytopenia and relative eosinophilia. The patient had increased total serum IgE levels and tested positive for 5-hydroxyindoleacetic acid in a 24-hour urine test from the very beginning of ur...

2012

Background and AimsThe HIV infection is associated with several dermatological conditions which may be the first pointer towards the existence of HIV. These may present with unusual and atypical manifestations in the course of the HIV infection. Keeping this in mind, the seroprevalence of HIV in these persons and the spectrum of the skin and the mucocutaneous lesions in the HIV positive patients was studied.MethodsThe current prospective study was conducted over a period of 3 years (2006-2008). A total of 604 persons who had any kind of skin and mucocutaneous infections were screened for the HIV infection as per the NACO guidelines after recording their clinical and epidemiological profiles.ResultsOut of the 604 patients who were screened, 90(14.90%) were seropositive for the HIV-I antibodies and none was positive for the HIV-2 antibodies. Seventy three point thirty three percent 73.33 of the seropositive patients were in the age group of 15-40 years, with a male-female ratio of 1:1.05. The heterosexual route was the most common mode of transmission (86.6%).A wide range of infectious and noninfectious lesions were observed. In the HIV seropositive patients, oral candidiasis (32.22%) was the most common infectious disease which was observed, followed by herpes zoster (13.33%), genital warts (7.77%) and genital herpes (6.66%). The most common noninfectious manifestation was seborrhoic dermatitis (8.88%), followed by pruritic papular eruptions (7.77%).ConclusionAs there is a high prevalence of the HIV infection in patients who have skin and mucocutaneous disorders, the doctors, during the investigation of these patients, must have a high level of suspicion for the HIV infection in their mind. An early detection of HIV optimizes the chemoprophylaxis for many opportunistic mucocutaneous disorders.

Open Forum Infectious Diseases, 2023

A 33-year-old man with human immunodeficiency virus (HIV) diagnosed 6 months ago (nadir CD4 count of 23 cells/µL, current CD4 count of 31 cells/µL) presented to the outpatient clinic with a 2-month history of subjective fevers and disseminated skin lesions. He was started on tenofovir, emtricitabine, efavirenz, trimethoprim-sulfamethoxazole, and azithromycin at the time of his HIV diagnosis. However, the patient only took his medications for 1 month and then was lost to follow up. Five months after his HIV diagnosis, he developed several erythematous-violaceous maculopapular skin lesions on upper extremities. Over 2-3 weeks, new lesions appeared over the trunk, lower extremities, and face. The lesions were painless and not pruritic. He denied any history of a similar illness/ rash. He was born in Paraguay and worked as a cashier in Asuncion. He denied sick contacts, domestic or international travel, pets, illicit drug use, or allergies to medications. His family history was noncontributory. The patient was sexually active with his wife and reported a mutually monogamous relationship. On exam, the patient had vital signs within normal range and appeared well nourished. Multiple erythematous

SANAMED, 2021

Objective: HIV/AIDS represents a significant public health issue since the number of cases is continuously on the rise. Even though contemporary medicine is rapidly developing, there is currently no effective cure for HIV. Mucocutaneous manifestations often represent the first recognized clinical manifestation. This study was carried out to note different presentations of HIV/AIDS on the skin. Material and Methods: The study included 150 patients who were hospitalized and have been confirmed as HIV positive either before the hospitalization or during the hospitalization. Results: Out of 150 patients, 50 of them had mucocutaneous presentations. Frequently, mucocutaneous lesions are the first manifestation of HIV/AIDS and a pointer toward setting up HIV/AIDS diagnosis. Moreover, the same patient was admitted more than once, because of a variety of skin manifestations. Conclusion: It was recognized that the greater the destruction of the immune system is, the more severe forms of mucoc...