SKIN DISEASES REVEALING HUMAN-IMMUNODEFIC IENCY-VIRUS INFECTION IN MALI

Introduction: Several skin diseases are associated with human immunode ficiency virus (HIV) infection. In Africa, due to the difficult access to medical care and complementary examinations, certain diseases are of particular importance. In the present work, we report the skin mani festations observed in a dermatology unit of a large city in Africa ov er a 3 year period and which were the revealing signs of HIV infection . Patients and methods : All adult subjects (> 15 years) with a positi ve HIV serology (confirmed by Western blot) that had been revealed by a skin disease seen at the Marchoux Institute at Bamako between June 1 991 and September 1994 were included in the study. Results : Two hundr ed sixty-three skin diseases revealed 233 cases of HIV infection. Dise ases observed were: tester (n = 71), seborrheic dermatitis (n = 43), K aposi's sarcoma (n = 34), prurigo (n = 31), sexually transmitted disea ses (n = 27), extensive dermatophytosis (n = 12), psoriasis (n = 12), molluscum contagiosum (n = 8), acquired ichthyosis (n = 3), cutaneous leishmaniasis (n = 2) and other skin diseases (n = 10). More than one disease were associated in 28 patients. Certain particular features we re noted (superinfection of tester, papular margin in dermatophytosis) . Discussion : In Africa, certain skin diseases often reveal HIV infec tion and some diseases have a high positive predictive value for HIV i nfection (tester, seborrheic dermatitis, prurigo, Kaposi's sarcoma, ex tensive dermatophytotis). For prognosis, frequently associated disease s are signs of AIDS (Kaposi's disease, prurigo, molluscum contagiosum) .