DERMATOLOGICAL FINDINGS CORRELATED WITH CD4 LYMPHOCYTE COUNTS IN A PROSPECTIVE 3 YEAR STUDY OF 1161 PATIENTS WITH HUMAN-IMMUNODEFICIENCY-VIRUS DISEASE PREDOMINANTLY ACQUIRED THROUGH INTRAVENOUS DRUG-ABUSE

Several prospective studies on dermatological findings in human immuno deficiency virus (HIV) type 1 infected patients have been published, m ostly in populations in which the predominant risk factor for HIV infe ction is homosexuality We attempted to identify cutaneous diseases ass ociated with HIV-1 infection and to assess disease progression in a co hort of Spanish patients in whom the predominant cause of HIV infectio n was intravenous drug abuse. We prospectively examined 1161 HIV-1-pos itive patients for 38 months. Seventy-four per cent of patients were i ntravenous drug abusers, whereas heterosexual contact was the only ris k factor in 14% and homosexuality in 9%. Centers for Disease Control s tage II disease predominated (51%), whereas stage IV disease was less frequent (39%). The mean CD4 count was 353/mm(3). We took patients' pa st and present medical history and performed a complete physical exami nation as well as taking photographs and carrying out the necessary di agnostic procedures. CD4 counts/mm(3) were measured at each visit. A d iagnosis of cutaneous disease was made in 799 patients (69%). Oral can didiasis and seborrhoeic dermatitis were the most common skin disorder s, followed by xerosis, drug eruptions, dermatophytosis and the papula r eruption of acquired immunodeficiency syndrome. Condyloma acuminatum , herpes tester and herpes simplex were the most frequent viral infect ions. Conditions that have a statistically significant association wit h advanced stage and low CD4 levels include drug eruptions, xerosis, l ight reactions, diffuse alopecia, herpes simplex, oral candidiasis, ps oriasis, oral hairy leucoplakia, molluscum contagiosum, Kaposi's sarco ma, furuncles, candidal intertrigo, folliculitis and ungual infection, as well as onychomycosis and tinea pedis or manuum. Dermatoses common ly associated with homosexuality such as Kaposi's sarcoma and oral hai ry leucoplakia, were rare in our patients.