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Giornale Italiano di Dermatologia e Venereologia 1998 June;133(3):163-70

Copyright © 1998 EDIZIONI MINERVA MEDICA

language: Italian

Skin diseases in children with HIV infection

Patrizi A. 1, Neri I. 1, Trestini D. 1, Ricci G. 2, Masi M. 2

1 Università degli Studi - Bologna, Dipartimento di Medicina Clinica Specialistica e Sperimentale; 2 Unità complessa di Scienze Pediatriche, Mediche Chirurgiche, III Clinica Pediatrica


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Background. The acquired immunodeficiency syndrome (AIDS) in children is now to be considered a clinical entity separate and distinct from AIDS in adults. The majority of children become infected by trasmission of the virus from an infected mother. Several dermatological manifestations have been associated with the syndrome in children including candidiasis, dermatophyte infection, molluscum contagiosum, herpes simplex and zoster, bacterial infections, malignant neoplasias and hyperproliferative epidermal disorders. In general, cutaneous infections tend to be more severe and less responsive to conventional treatment than in healthy children.
Objective. Personal experience regarding muco-cutaneous manifestations of human immunodeficiency virus infection and acquired immunodeficiency syndrome in children is presented.
Methods. Fourteen children vertically infected with HIV, were evaluated for CD4+cell count, CD4+/CD8+ ratio and presence of muco cutaneous diseases.
Results. The severity of dermatologic manifestations appeared to be related to the immune status of the patients. More severe CD4+ cell depletion was associated with a wider spectrum and increased severity of dermatologic manifestations.
Conclusions. This study confirms the large spectrum of cutaneous manifestations in children with HIV infection which are similar to those usually reported in the literature. Skin diseases may represent one of the first signs of the HIV infection and may also serve to alert the physician to a deterioration of the immunocompetence of the patient. In fact, the more severe cutaneous manifestations which are also less responsive to treatment appear when the number of CD4+lymphocytes is under 200 cells/ mmc.

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