Frequency of mucocutaneous manifestations in HIV positive Pakistani patients


  • Nadia Ali Azfar
  • Abdur Rahim Khan
  • Muhammad Ali Zia
  • Asif Humayun
  • Lamees Mahmood Malik
  • Muhammad Jahangir


Cutaneous manifestations, HIV, CD4 count


Background Mucocutaneous manifestations are commonly observed in HIV patients. These range from various opportunistic infections, inflammatory dermatoses to neoplasms and drug reactions. Objective To observe the nature and frequency of mucocutaneous manifestations in patients of HIV, with or without antiretroviral therapy and their correlation with CD4 cell counts. Patients and methods The duration of study was one year, starting from July 2009 to July 2010. The patients were enrolled from the HIV clinic and inpatient departments of Jinnah Hospital Lahore. Patients meeting the inclusion and exclusion criteria were subjected to a detailed history and clinical examination. Investigations were carried out where required. Treatment profile was also noted. The data was recorded on a pro forma and was analyzed later. Results A total of sixty two patients were enrolled in the study. There were 49 (79%) males and 13 (21%) females. The age range was 4 to 58 years. Cutaneous manifestations were seen in 51 (82%) patients. The most common cutaneous findings were fungal infections seen in 33.87% patients, followed by viral infections (29.03%), xerosis (22.58%) and bacterial infections (12.9%). Less common manifestations were photosensitivity, scabies and hyperpigmentation. CD4 cell count was found to be more than 455x109 in 22 patients while it was less than 455x109 in 40 patients. Skin manifestations were found in 19 (86.36%) patients with a high count and in 33 (82.5%) patients with a low count. Conclusion Cutaneous manifestations are commonly seen in patients of HIV infection. 


Worldwide HIV and AIDS statistics.[Online] 2009 [cited: 2010 Jan 22] Available from: http:// stats.htm

Erdal E. Cutaneous Manifestations of HIV Disease. [Online]. [cited: 2009 Aug 12] Available from :http:// article/ 1133746- overview

USAIDS HIV/AIDS Health Profile for Pakistan-November 2010 [Online] [cited: 2011 Feb 8] Available from: http: //

Tschachler E, Bergstresser PR, Sting IG. HIV related skin diseases. Lancet 1996; 348: 659-63

Uthayakumar S, Nandwani R, Drinkwater T et al. The prevalence of skin disease in HIV infection and its relationship to the degree of immunosuppression. Br J Dermatol 1997; 137: 595-8

Coldiron BM, Bergstresser PR, Stingl G. HIV-related skin diseases. Lancet1996; 348: 659-63.

Goodman DS, Teplitz ED, Wishner A et al. Prevalence of cutaneous disease in patients with An AIDS- related complex. J Am Acad Dermatol 1987; 17: 210-20.

Supanaranond W, Varunee D, Sitakalin C et al. Cutaneous manifestations in HIV positive patients. Southeast Asian J Trop Med Public Health 2001; 32:171-6.

Singh H, Singh P, Tiwari P et al. Dermatological manifestations in HIV- infected patients at a tertiary care hospital in a tribal (Bastar) region of Chhattisgiah, India. Epidemiology Round 2009; 54: 338-41.

Spira R, Mignard M, Doutre MS. Prevalence of cutaneous disorders in a population of HIV infected patients. Arch Dermatol 1998; 134: 1208-12.

Jeffery HS, Muz P, Cabral P, Jhomb K. Dermatological manifestations in HIV infected patients. Mayo Clinic Proc 1999; 74: 658-60.

Pitche P, Techangai-Walla K, Napo-Koura G et al. Prevalence of skin manifestations in AIDS patients in the Lome-Tkom University Hospital (Togo). Sante 1995; 5: 349-52.

Pai G. Cutaneous manifestations of HIV infection. Indian J Dermatol Venereol Leprol 1997; 63: 35-7.

Shobana A, Guha SK, Neogi DK. Mucocutaneous manifestations of HIV infection. Indian J Dermatol Venereol Leprol 2004; 70: 82-6.

Rowe A, Mallon E, Rosenberger P et al. Depletion of cutaneous peptidergic innervation in HIV-associated xerosis. J Invest Dermatol 1999; 112: 284-9.

Mathes LE, Hayes KA, Kociba G. Evidence that high-dose zidovudine at the time of retrovirus exposure reduces antiviral efficacy. Antimicrob Agents Chemother 1996; 40: 2183-6.

Brannon H. Seborrheic dermatitis and AIDS. [Online] 2006 [cited: 2010 Dec 6] Available from: 8905.htm

Rad F, Ghaderi E, Moradi G, Mafakheri L. The relationship between Skin manifestations and CD4 counts among HIV positive patients. Pak J Med Sci .2008; 24: 114-7.

Borras-Blasco J, Navarro-Ruiz A, Borras C, Castera E. Adverse cutaneous reactions associated with the newest antiretroviral drugs in patients with human immunodeficiency virus infection. J Antimicrob Chemother 2008; 62: 879-88.

Coopman SA, Lohnson RA, Platt R, Stern RS. Cutaneous disease and drug reaction in HIV infection. N Eng J Med 1993; 328: 1670-4.

Raju PV, Rao GR, Ramani TV, Vandana S. Skin disease: clinical indicator of immune status in humans immunodeficiency virus (HIV) infection. Int J Dermatol. 2005; 44: 705-6.




How to Cite

Azfar NA, Khan AR, Zia MA, Humayun A, Malik LM, Jahangir M. Frequency of mucocutaneous manifestations in HIV positive Pakistani patients. J Pak Assoc Dermatol [Internet]. 2016Dec.22 [cited 2024Jun.17];21(3):149-53. Available from:



Original Articles

Most read articles by the same author(s)

1 2 3 4 5 > >>