Prostate Cancer Screening
Newborn Screening
The Thromboelastogram
Community-acquired MRSA
Diagnostic Utility of Skin Biopsy
Diagnosis of Sepsis
Osteoporosis in Men
Oral Anticoagulant Therapy
Patient with Allergy
Cytology
Role of Vancomycin
Estimated average glucose
Fungitell Option 2
Evolving role of Troponins
Aspirin Resistance
Tumor Markers
Sentinel Lymph Node Biopsy
Swine Influenza
Syphillis
Hereditary Haemochromatosis
Haematological Changes in HIV
Influence of HIV
Drug induced liver injury
 

Skin Biopsy

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Diagnostic Utility of the Skin Biopsy in HIV Infection and AIDS

An estimated 38.6 million people worldwide are living with human immunodeficiency virus (HIV) infection or the acquired immunodeficiency syndrome (AIDS) according to the 2006 UNAIDS survey. Sub-Saharan Africa continues to represent the global epicentre of this pandemic. This places an enormous burden on financial and health resources in countries (which include South Africa) most severely affected by the disease.

Skin disease is often the first presenting feature of HIV infection or AIDS. More than 90% of patients with HIV/AIDS will develop one or more skin diseases during the course of their illness. The skin disease picture and skin disease spectrum may vary in the face of a declining CD4 count. A skin biopsy may provide the first opportunity to diagnose an unsuspected and potentially life-threatening opportunistic infection, especially in patients who have not had access to highly active anti-retroviral therapy (HAART).

All medical practitioners working in regions of the world where HIV/AIDS is prevalent ideally should be familiar with the spectrum of cutaneous manifestations of HIV/AIDS. These include a range of non-infective dermatoses, infectious diseases (often opportunistic) caused by viruses, bacteria, fungi, protozoa and even arthropods, and neoplastic conditions such as Kaposi's sarcoma (KS) and B-cell non-Hodgkin lymphoma (NHL). The non-infective dermatoses may be classified as follows:

Dermatoses peculiar to HIV infection (eg HIV exanthem, papular pruritic eruption of HIV infection).

Common dermatoses occurring with greater frequency or modified by HIV/AIDS (eg seborrhoeic dermatitis, psoriasis).

Less common conditions that have been reported in

The risk for adverse skin reactions to certain drugs is also greatly increased. Although the introduction of HAART has resulted in a dramatic decrease in opportunistic infections, several of these drugs may result in adverse reactions in the skin. The spectrum of potential adverse drug reactions in patients receiving HAART is large, and includes exanthematous (morbilliform) drug eruptions, drug hypersensitivity (“DRESS”), Steven's-Johnson syndrome, toxic epidermal ecrolysis, mucocutaneous pigmentation, leucocytoclastic vasculitis, lipodystrophy syndromes, etc.

 

 

 

 

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