Abstract
In Africa where there are limited laboratory resources for human immunodeficiency virus (HIV) testing the presence of seborrheic dermatitis--common in early stages of infection--may have potential as a clinical marker for HIV. To assess the predictive value of this skin disease a prospective study was conducted at the Institut Marchoux in Bamako Mali in 1992-94. The 305 study participants whose HIV status was unknown at study entry were grouped by dermatologic condition; in 21 cases two or more dermatoses were present. 159 of these patients were found to be HIV-positive. The HIV rates by condition were as follows: seborrheic dermatitis (28/58 patients or 48%) psoriasis (10/48 patients 21%) widespread dermatophytosis (11/33 patients 33%) molluscum contagiosum (8/17 patients 47%) herpes zoster (64/81 patients 79%) Kaposis sarcoma (31/31 patients 100%) prurigo (27/59 patients 46%) and associations of several dermatoses (19/21 patients 90%). The proportions of seropositive patients with two or more clinical signs of acquired immunodeficiency syndrome (AIDS) were 18% 10% 9% 75% 27% 74% and 52% respectively. Thus Kaposis sarcoma prurigo and molluscum contagiosum were the dermatologic conditions most frequently associated with clinical indicators of a poor prognosis. Seborrheic dermatitis on the other hand has a high prevalence in HIV-infected persons but a relatively early occurrence in HIV natural history (evidenced by its low association with full-blown AIDS) making it a useful indicator of HIV infection in African populations.
Published Version
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