Characteristics of HIV Infected Patients with Biopsy Diagnosed Spongiotic Dermatitis

Gus W Krucke,Deanna E Grimes,Richard M Grimes,Benjamin L Cooper

doi:10.4236/wja.2011.14021

Abstract

Purpose. Twenty-six HIV patients with biopsy diagnosed spongiotic dermatitis (SD) were studied to determine their demographic and clinical characteristics. The condition was also investigated to determine if it was linked to the immune reconstitution inflammatory syndrome (IRIS). Methods. All patients whose skin biopsies were diagnosed by a pathologist as SD were identified. Medical records were reviewed to extract demographic descriptors, viral loads and CD4+ counts at the time that SD occurred. In an attempt to determine if the condition could be linked to Immune Reconstitution Syndrome (IRIS), the time from nadir CD4+ count to the occurrence of SD was determined. Results. SD patients were found to be older than expected but were similar to other clinic patients with regard to race/ethnicity and gender. CD4+ counts, viral loads were not related to SD. SD did not seem to be related to IRIS because few cases occurred within the time frame associated with IRIS. SD frequently appeared on the limbs although the literature suggests a more frequent appearance on the trunk and buttocks. Discussion. HIV clinicians may expect to see SD on occasion and it may appear in unusual body sites and at any time during the course of the infection.

Highlights

Spongiotic dermatitis (SD), an intensely pruritic dermatologic condition, is diagnosed by biopsy [1]
Twenty six of these specimens were classified as spongiotic dermatitis by a pathologist
All of the CD4+ counts and viral loads were performed within two months of the skin biopsy

Summary

Introduction

Spongiotic dermatitis (SD), an intensely pruritic dermatologic condition, is diagnosed by biopsy [1]. Lesions of this condition are typically found on the trunk or buttocks but may appear on any part of the body. In the absence of effective treatment, the skin may become rough, ooze and crust and constant scratching may lead to scarring. SD has been linked to infectious conditions such as hepatitis C infection [3] and HTLV-1 infection [4]. A variant of SD is has been found in patients with heavily pigmented skin [5]. Investigators have noted high levels of proliferative activity of CD8 (+) T cells in patho-

Methods

Results

Conclusion