INCREASED ANTICARDIOLIPIN ANTIBODIES ASSOCIATED WITH THE DEVELOPMENT OF ANETODERMA IN HIV-1 DISEASE

Background and Objective. Anetoderma has been reported in patients wit h HIV-1 disease. In patients with autoimmune disease, anetoderma has b een associated with increased levels of antiphospholipid antibodies (A PL) that include anticardiolipin antibodies (ACA) and lupus anticoagul ant (LA). This has led to speculation that the autoimmune phenomena se en in HIV-1 disease and the immune dysregulation induced by HIV-1 dise ase may play a role in the development of these lesions. We have seen both primary and secondary lesions of anetoderma in patients followed for HIV-1 disease. In this study, we wanted to determine whether there was an association in the development of anetoderma and elevated anti cardiolipin antibodies (ACA) in HIV-1 patients. Methods. Quantitative ACA levels were measured in eight HIV-1-infected patients with anetode rma and four HIV-1-infected patients without anetoderma. Results. Anti cardiolipin antibodies were moderately elevated in seven of eight pati ents with lesions and were borderline in the four HIV-1-positive patie nts without lesions of anetoderma. Conclusions. There appears to be a correlation between increased ACA and the development of cutaneous les ions of anetoderma in HIV-1 disease. Patterns of immune dysregula-tion , including APL, may predispose to the development of lesions of aneto derma in HIV-1-positive patients. Although some of the lesions appear to represent primary anetoderma, the majority of our patients develop lesions in areas secondary to well characterized eruptions.