DERMATOLOGICAL DISORDERS ASSOCIATED WITH HIV INFECTION OUR EXPERIENCE IN ETHIOPIA

Morrone A., Terranova M., Padovese V.

21° WORLD CONGRESS OF DERMATOLOGY
Buenos Aires, September 30 – October 5 2007

Background
Sub-Saharan Africa, has the highest incidence of HIVAIDS infection in the world.
Lack of access to necessary antiretroviral therapy leads to the increased presence of advanced AIDS and severe pathological conditions related to the infection. The skin represents a sensible indicator of HIV infection and multiple skin disorder are part of the list established from WHO for the staging of HIV/AIDS
Patients and Methods
We report our experience at the Italian Dermatological Centre (IDC) in Mekele, Tigray, the northernmost regional state in Ethiopia. From January 2005 to January 2007, 736 HIV positive patients have been examined with related skindisorders.
Discussion
Commonest alterations we recorded included impetigo, dermatophytosis, viral warts and mol¬luscum contagiosus.
Atypical clinical presentations (extensive distribution of the skin lesions or presence of multiple infections in the same patient) represented HIV indicator. Papular Pruritic Eruption (PPE) represented an important role in the early detection of HIV infection and one of the most common symptoms encountered in patients with HIV. It is a not-infectious skin disorder, which involve not only the body but also the face, permitting in this way the immediate diagnosis of HIV infection. Investigations for STIs, according to the literature, showed high incidence in HIV patients and, in our experience, genital warts represented the commonest.
ISMAS, in collaboration with the Italian Cooperation-HSPD, Tigray Regional Health Bureau and Tigray Medical Association is leading an operational research (OR) to spread information about the strong relation between HIV infection and skin disorders. The aim of this project is to improve diagnosis and management skill of peripheral health workers on common skin condition related to HIV/AIDS.
Conclusions
Dermatological knowledge represents one of the fundamental clinical bases to diagnose HIV infection worldwide. We believe in the importance of spreading this dermatological skill to permit early detection and diagnosis of HIV infection.
For this reason, as part of the OR, we are teaching dermatological discipline in multiple district of Tigray region. Early diagnosis represents one of the aims to decrease mortality HIV-related.
References
1. Niamba P, Goumbri-Lompo O, Traore A, Barro-Traore F, Soudre RT. Diffuse cutaneous leishmaniasis in an HIVpositive patient in western Africa. Australas J Dermatol. 2007 Feb;48(1):32-4
2. Holmes CB, Losina E, Walensky RP, Yazdanpanah Y, Freedberg KA. Review of human immunodeficiency virus type 1-related opportunistic infections in sub-Saharan Africa. Clin Infect Dis. 2003 Mar 1;36(5):652-62.