Characteristics of HIV Infected Patients with Biopsy Diagnosed Spongiotic Dermatitis

Gus W. Krucke, Benjamin L. Cooper, Deanna E. Grimes, Richard M. Grimes
DOI: 10.4236/wja.2011.14021                

Abstract

Purpose. Twenty-six HIV patients with biopsy diagnosed spongiotic dermatitis (SD) were studied to determine their demographic and clinical characteristics. The condition was also investigated to determine if it was linked to the immune reconstitution inflammatory syndrome (IRIS). Methods. All patients whose skin biopsies were diagnosed by a pathologist as SD were identified. Medical records were reviewed to extract demographic descriptors, viral loads and CD4+ counts at the time that SD occurred. In an attempt to determine if the condition could be linked to Immune Reconstitution Syndrome (IRIS), the time from nadir CD4+ count to the occurrence of SD was determined. Results. SD patients were found to be older than expected but were similar to other clinic patients with regard to race/ethnicity and gender. CD4+ counts, viral loads were not related to SD. SD did not seem to be related to IRIS because few cases occurred within the time frame associated with IRIS. SD frequently appeared on the limbs although the literature suggests a more frequent appearance on the trunk and buttocks. Discussion. HIV clinicians may expect to see SD on occasion and it may appear in unusual body sites and at any time during the course of the infection.

Keywords

Spongiotic Dermatitis, HIV Infection, Immune Reconstitution Inflammatory Syndrome

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	K. Gupta, “Deciphering Spongiotic Dermatitides,” Indian Journal of Dermatology Venereolology and Leprology, Vol. 74, No. 5, 2008, pp. 523-526. doi:10.4103/0378-6323.44332
[2]	M. Jeffries, “What Is Spongiotic Dermatitis?” 2010. http://ezinearticles.com/?What-Is-Spongiotic-Dermatitis?&id=1068322
[3]	Gruppo Italiano Studi Epidemiologici in Dermatologia (GISED), “Lichen Planus and Liver Diseases: A Multicentre Case-Control Study,” British Medical Journal, Vol. 300, No. 6719, 1990, pp. 227-230. doi:10.1136/bmj.300.6719.227
[4]	R. R. Bonamigo, K. Borges, J. Rietjens, S. Arenzon, L. P. Blanco and R. Loureiro, “Human T lymphotropic Virus 1 and Hepatitis C Virus as Risk Factors for Inflammatory Dermatoses in HIV-Positive Patients,” International Journal of Dermatology, Vol. 43, No. 8, 2004, pp. 568- 570. doi:10.1111/j.1365-4632.2004.02179.x
[5]	B. T. Summey, S. E. Bowen and H. B. Allen, “Lichen Planus-Like Atopic Dermatitis: Expanding the Differential Diagnosis of Spongiotic Dermatitis,” Journal of Cutaneous Pathology, Vol. 35, No. 3, 2008, pp. 311-314. doi:10.1111/j.1600-0560.2007.00806.x
[6]	M. Deguchi, H. Ohtani, E. Sato, Y. Naito, H. Nagura, S. Aiba and H. Tagami, “Proliferative Activity of CD8(+) T Cells as an Important Clue to Analyze T Cell-Mediated Inflammatory Dermatoses,” Archives Dermatology Research, Vol. 293, No. 9, 2001, pp. 442-447. doi:10.1007/s004030100255
[7]	M. M. Khambaty, “Dermatology of the Patient with HIV,” Emergency Medicine Clinics of North America, Vol. 28, No. 2, 2010, pp. 355-368. doi:10.1016/j.emc.2010.01.001
[8]	P. K. Ramdial, “Dermatopathological Challenges in the Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome Era,” Histopathology, Vol. 56, No. 1, 2010, pp. 39-56. doi:10.1111/j.1365-2559.2009.03456.x
[9]	G. E. Rodwell and T. G. Berger, “Pruritus and Cutaneous Inflammatory Conditions in HIV Disease,” Clinics in Dermatology, Vol. 18, No. 4, 2000, pp. 479-484. doi:10.1016/S0738-081X(99)00143-1
[10]	D. Rigopoulos, V. Paparizos and A. Katsambas, “Cutaneous Markers of HIV Infection,” Clinics in Dermatology, Vol. 22, No. 6, 2004, pp. 487-498. doi:10.1016/j.clindermatol.2004.07.007
[11]	J. Luther and M. J. Glesby, “Dermatologic Adverse Effects of Antiretroviral Therapy,” American Journal of Clinical Dermatology, Vol. 8, No. 6, 2007, pp. 221-233. doi:10.2165/00128071-200708040-00004
[12]	S. Mori and P. Levin, “A Brief Review of Potential Mechanisms of Immune Reconstitution Inflammatory Syndrome in HIV Following Antiretroviral Therapy,” International Journal of STD & AIDS, Vol. 20, No. 7, 2009, pp. 447-452. doi:10.1258/ijsa.2009.008521
[13]	S. A. Shelburne, F. Visnegarwala, J. Darcourt, E. A. Graviss, T. P. Giordano, A. C. White Jr. and R. J. Hamill, “Incidence and Risk Factors for Immune Reconstitution inflammatory Syndrome during Highly Active Antiretroviral Therapy,” AIDS, Vol. 19, No. 4, 2005, pp. 399-406. doi:10.1097/01.aids.0000161769.06158.8a