MUCOCUTANEOUS MANIFESTATIONS OF HIV/AIDS IN ADOLESCENTS

Size: px

Start display at page:

Download "MUCOCUTANEOUS MANIFESTATIONS OF HIV/AIDS IN ADOLESCENTS"

Ashlynn Owen
5 years ago
Views:

1 MUCOCUTANEOUS MANIFESTATIONS OF HIV/AIDS IN ADOLESCENTS Dr. Y.S.MARFATIA Prof. and Head, Dept. Skin & V.D. Medical college, Vadodara LET US CREATE BRILLIANCE TOGETHER

2 MEDICAL COLLEGE, VADODARA

3 Editor in Chief DrY.S.Marfatia Call for articles on STD HIV/AIDS Non venereal genital conditions HIV dermatology Sexual Medicine For online submission:

4 Introduction Mucocutaneous manifestations occur in more than 90% of HIV infected cases. There is a dearth of data concerning Mucocutaneous manifestations in Adolescents suffering from HIV/AIDS. These manifestations may be cosmetically disfiguring and source of severe morbidity, both physical and psychological, more so in adolescents.

5 Aim To study different mucocutaneous manifestations of HIV/AIDS in adolescents A. Whether they occurred as presenting manifestations of HIV or as part of ADR of ART B. In what proportion did they cause cosmetic disfigurement

6 Material & methods Forty seven HIV positive adolescents (10-19 years) attending Skin VD OPD, Medical College, from January 2008 to May 2011 were studied. Thorough history was taken and clinical examination was carried out to diagnose any mucocutaneous manifestations. Extensive and visually prominent lesions or lesions leading to scarring were considered as cosmetically disfiguring.

7 Results & Discussion Infectious & Non-infectious manifestations Number of Patients Infectious manifestations 25 Non-Infectious manifestations 10 Infectious and Non Infectious Manifestations 2 Total Cases 37 Thirty Seven (79%)out of 47 Cases had mucocutaneous manifestations

8 Dermatological manifestations as PRESENTING FEATURE of HIV/AIDS(n=47) Condition No. of cases Oral candidiasis 2 Recurrent pruritic papular eruptions 2 Scrofuloderma 1 Multiple giant molluscum contagiosum lesions over eye 1 Recurrent boils 1 Total 7(15%)

9 Category Bacterial Viral Fungal Infectious manifestations among HIV + adolescent (n=47) Infections Boils 3 Scrofuloderma 1 Herpes simplex (HSV) 2 Herpes zoster (HZV) 7 Molluscum contagiosum 3 Oral Hairy Leukoplakia 1 Warts (HPV) 2 Dermatophytic infection 3 Oral candidiasis 7 Parasitic Scabies 2 Total Manifestations 31 No. of manifestations 27 Cases (57%) had infectious mucocutaneous manifestations of which 4 cases had multiple infections.

10 Scrofuloderma Molluscum Contagiosum

11 Condition ADR of ART Non-Infectious manifestations among HIV + adolescents (N=47) No. of manifestaions Nevirapine induced maculopapular rash 3 Stavudine induced lipodystrophy 1 Pruritic papular eruptions (PPE) 3 Seborrheic dermatitis 2 Ichthyosis 2 Nails- Melanonychia 1 Hair- cicatricial alopecia 1 Total Non-Infectious manifestations 13* 12 (25%)Cases had non infectious manifestations * One case had Seborrheic dermatitis with Stavudine induced Lipodystrophy

12 Cicatricial alopecia following Tinea Capitis Pruritic Papular Eruptions

13 Stavudine induced Lipodystrophy

14 Cosmetically Disfiguring Dermatological manifestations were present in 15/47 (32%) Condition No. of cases (n=15) Post-Herpetic scarring 7 Pruritic papular eruptions 3 Ichthyosis 1 Tinea capitis with cicatricial alopecia 1 Stavudine induced lipodystrophy 1 Scrofuloderma (neck) 1 Extensive warts 1

15 Post Herpetic Scarring

16 Summary Four-fifth of adolescents infected with HIV developed mucocutaneous manifestations. One fifth of cases in our study had mucocutaneous manifestations as presenting features of HIV, providing an opportunity for dermatologists to diagnose HIV. There were 4/47(9%)cases suffering from Mucocutaneous ADR due to ART.

17 Summary Major issue is the cosmetically disfiguring lesions in 32% cases and morbidity associated with these manifestations leading to psychological impact on this vulnerable age group. Since these patients are expected to take ART lifelong, they have increase chances of suffering from various metabolic and disfiguring side effects.

18 Conclusion Adolescents with HIV/AIDS have a long life, having issues related to the disease and the treatment compounded by disfiguring Muco-cutaneous manifestations having physical stigma and emotional trauma. Early diagnosis of HIV and opportunistic infections (OI) and prevention and management of cosmetically disfiguring lesions will go a long way in improving the quality of life of such adolescents. ADOLESCENT HIV/AIDS AN EPIDEMIC WITH DIFFERENCE & ITS CONTROL NEEDS TO BE ADOLESCENT SPECIFIC

be the presenting symptom of HIV-related illness. 4 CD4 cell count and CD4 cell percentage are key markers for determining disease progress and the ri

be the presenting symptom of HIV-related illness. 4 CD4 cell count and CD4 cell percentage are key markers for determining disease progress and the ri Cutaneous Maniestations In HIV Positive Paediatric Patients Kondreddy B 1, Kuruvila M 2, Ullal KR 3, Bhat K 4 1 Resident, 2 Professor, 3 Senior Resident, Department of Dermatology, Venereology and Leprosy,