Clinical characteristics of seborrheic dermatitis in HIV-infected patients

Objective. To identify the clinical characteristics of seborrheic dermatitis (SD) in HIV-infected patients according to HIV infection stage, immune status, and viral load. Subjects and methods. A total of 401 patients with SD were followed up. A study group included 198 (49.4%) HIV-infected patients; a comparison group consisted of 203 (50.6%) HIV-negative patients. The dermatology index (Perioral Dermatitis Severity Index (PODSI)/ITPOD) was determined to assess the severity of SD symptoms. In addition to conventional studies, the investigators determined HIV RNA levels by PCR on an iCycler (Austria), by using the AmpliSens HIV-Monitor test system (Central Research Institute of Epidemiology of Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Russia) and estimated the counts of CD3+, CD4+, and CD8+ lymphocyte subpopulations on a FACS Calibur flow cytometer (Becton Dickinson, USA). Results. The onset or exacerbation of skin disease was observed in 372 (92.7%) patients within 6 months to 3 years before their inclusion in the study. The progression/exacerbation of SD at the stage of secondary diseases was noted in 140 (76.5%) patients of the study group. The process was sluggish and continuously recurring in 33.5% of cases. The concurrence of the two skin pathologies was observed in 46.1% of patients in both groups, while the compatibility was 73.2% in the study group. At the beginning of the study, obvious immunodeficiency was seen in patients at the stage of secondary diseases (the CD4+ lymphocyte counts was less than 350 cells/ml in 101 patients), while the viral load was more than 103 copies for HIV RNA; 71 patients were noted to have moderate-to-severe and severe SD requiring continuous drug therapy. Conclusion. Taking into account the correlation of the intensity of cutaneous manifestations of SD with the clinical stage of HIV infection, viral load, and CD4+ lymphocyte counts, the quantitative and qualitative assessment of the recording of morphological alterations of the skin can serve as a prognostic criterion for the course of HIV infection.

seborrheic dermatitis, HIV infection, perioral dermatitis severity index, viral load