DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20214156

A clinico epidemiological study of pediatric dermatoses of HIV infected children in a tertiary care hospital of North Bengal

Mrinmoy Bairagi, Tanushree Mandal, Balai Chandra Karmakar

Abstract


Background: Pediatric Human immunodeficiency virus (HIV) infection and its dermatological manifestation has emerged a serious burden globally including India. Dermatological manifestations are unique in pediatric HIV infection and related to CD4 cell count and its percentage. The study was carried out to assess the cutaneous manifestation of HIV positive pediatric patients and its correlation with CD4 cell count in eastern part of India below 12 years of age.

Methods: This analytic epidemiological study with prospective observational design was carried among 30 HIV positive children below 12 years of age in our institution over a period of one year.

Results: Total 30 HIV infected children were studied among male 23 (76.67%)) and female 7 (23.33%). Age ranged from birth to 12 years with mean was 6.39±2.48 years. The skin lesions are highest in 3-6 yrs age group 12 (40%) and 33.33% of them had CD4 counts between 500-750 while 3.33% had CD4 counts above 1500. 27 patients (90%) were received ART and 3 (10%) patients were without ART. Nine distinct patterns of lesions: abscess (3), furuncles (1), maculopapular rash (2), papular (7), pruritic (10), plaque (3), soreness of tongue (2), pustules (1) and red scaly (1) were detected. 46.67% pain (14), 40.0% itching (12) and 13.33% burning sensation (4) were the main symptoms and 20.0% face (6), 16.7% oral cavity (5), 20.0% hands (6), 10.0% abdomen (3) and 33.3% legs (10) were principal site of involvement. 13 different skin lesions: fungal infection (3), furuncles (1), urticaria (4), scabies (5), prurigo (5), measles (1), molluscum contagiosum (1), abscess (3), venous leg (1), pyoderma (1), atopic dermatitis (1), chicken pox (2) and glossitis (2) were diagnosed.

Conclusions: Various dermatological manifestations are common with pediatric HIV infection and sometime are the first clinical presentation that is well correlated with CD4 cell count and its percentage.  


Keywords


Dermatological manifestation, CD4 count, Pediatric HIV/AIDS infection

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References


Nath A. Pediatric HIV in India: Current scenario and the way forward. Indian J Public Health. 2017;61:124-30.

Grossman MC, Grossman ME. Chronic hyperkeratotic herpes zoster and human immunodeficiency virus infection. J Am Acad Dermatol. 1993;28:306‑8.

Boonchai W, Laohasrisakul R, Manonukul J, Kulthanan K. Pruritic papular eruption in HIV seropositive patients: A cutaneous marker for immunosuppression. Int J Dermatol. 1999;38:348‑50.

Karande S, Bhalke S, Kelkar A, Ahuja S, Kulkarni M, Mathur M. Utility of clinically‑directed selective screening to diagnose HIV infection in hospitalized children in Bombay. India. J Trop Pediatr. 2002;48:149‑55.

Wananukul S, Deekajorndech T, Panchareon C, Thisyakorn U. Mucocutaneous findings in pediatric AIDS related to degree of Immune suppression. Pediatr Dermatol. 2003;20:289‑94.

Madhivanan P, Mothi SN, Kumarasamy N, Yepthomi T, Venkatesan C, Lambert JS, et al. Clinical manifestations of HIV infected children. Indian J Pediatr. 2003;70:615‑20.

Sehgal R, Baveja UK, Chattopadhya D, Chandra J, Lal S. Pediatric HIV infection. Indian J Pediatr. 2005;72:925‑30.

Parthasarathy P, Mittal SK, Sharma VK. Prevalence of pediatric HIV in New Delhi. Indian J Pediatr. 2006;73:205‑7.

Kaplan MH, Sadick N, Scott McNutt N, Meltzer M, Sarngadharan M, Pahwa S. Dermatologic findings and manifestations of acquired immunodeficiency syndrome (AIDS). Journal of the American Academy of Dermatol. 1987;16(3): 485-506.

Nair SP, Mathew R. A clinico-epidemiological study of dermatoses in pediatric HIV patients in a tertiary care center. Indian J PaediatrDermatol. 2016;17:186-9.

George K. Siberry. Preventing and Managing HIV Infection in Infants, Children, and Adolescents in the United States. Pediatr Rev. 2014;35(7):268-86.