Histopathological Patterns of Skin Lesions in Adult Patients With Human Immunodeficiency Virus Attending a Clinic at the Mbagathi Level V Hospital, Nairobi, Kenya

Abstract

To describe the histopathological patterns of skin lesions in adult HIV patients attending a comprehensive care clinic at the Mbagathi level V hospital in Nairobi, Kenya. Patients were recruited and a structured questionnaire was used to collect social demographic and clinical data. Punch biopsies were done on the patients who met the inclusion criteria. Collected samples were fixed in 10% buffered formal saline. All samples were stained with H&E. Out of the 101 patients recruited, 60.3% (61/101) were females and the males were 39.7% (40/101). The patients’ age was normally distributed with a mean age of 37.7 years. Most patients had HIV for less than 2 years, and 79% (80/101) were on HAART. Most of the patients had inflammatory lesions (43.3%, 44/101) followed by malignant conditions (26.8%, 27/101), with Kaposi sarcoma being the commonest malignancy. There was a significant discordance between the clinical and the histopathological diagnosis in both the inflammatory and malignant categories (73% and 72%, respectively). Majority of the skin lesions were inflammatory dermatoses followed by Kaposi sarcoma. Histopathology is critical in diagnosing dermatological diseases in immunocompromised patients, particularly in inflammatory dermatoses and the malignancies where there is a significant discordance between the clinical and histopathological diagnosis.