Mucocutaneous disease in pediatric human immunodeficiency virus infection

Otolaryngologic manifestations of pediatric immunodeficiency

Many adults and children with an underlying immunodeficiency can frequently present to ear, nose and throat (ENT) surgeons. This work deals with the presentation, investigation and management of immuno-compromised children in ENT practise. Both primary immunodeficiencies (PID) and secondary or acquired immunodeficiencies such as human immunodeficiency virus (HIV) infection are here discussed. The aim of this work is to give a complete and exhaustive description of ENT manifestations in immunodeficiency, and to outline basic principles to guide clinical practice.

Pediatric HIV/AIDS and the skin: an update

In 2005 there were 2.1 million children under the age of 15 years living with HIV in sub-Saharan Africa. As in the adult pandemic, attendant skin disease is prevalent in children. This article provides an update of pediatric HIV/AIDS and its cutaneous manifestations from four main aspects: epidemiology, skin disease as an indicator of immune status, immune reconstitution inflammatory syndrome, and the impact of antiretroviral agents on skin disease.

Alterações dermatológicas em crianças com Aids e sua relação com categorias clínico-imunológicas e carga viral

FUNDAMENTOS: Desde o início da epidemia da Aids as dermatoses têm sido freqüentemente descritas em pacientes com essa doença, com relatos de casos atípicos e estudos de séries de pacientes adultos; no entanto, há poucas publicações sobre alterações cutâneas em pacientes pediátricos com Aids. OBJETIVOS: Estudo prospectivo para avaliar a presença de dermatoses em 40 pacientes pediátricos com Aids. MÉTODOS: Quarenta pacientes, com idade inferior a 13 anos e portadores de Aids, foram estudados por um período de seis meses para avaliação de: número de alterações dermatológicas; suas características clínicas; distribuição conforme as categorias clínico-imunológicas e o valor da carga viral. RESULTADOS: A prevalência de dermatoses foi de 82,4%, na primeira consulta, e, no acompanhamento longitudinal, 92,5% dos pacientes tiveram alterações dermatológicas, com proporção de cinco diagnósticos por doente. As crianças com classificação clínico-imunológica grave e carga viral acima de 100.000 cópias/ml apresentaram maior número de alterações dermatológicas quando comparadas àquelas das categorias clínico-imunológicas leves. A proporção de diagnósticos por paciente na categoria clínica C foi de 6,8 e na A de 3,6; na categoria imunológica grave, de sete, e na leve de 3,7; e na carga viral > 100.000 de 7,3, e na < 100.000 de 4,2 (todos com significância estatística). CONCLUSÃO: As dermatoses foram freqüentes nas crianças com Aids e ocorreram em maior número nos pacientes pertencentes às categorias graves. A elevada freqüência de alterações da pele nos pacientes pediátricos com a doença indica ser imprescindível sua avaliação dermatológica minuciosa e freqüente.

Otolaryngologic manifestations of human immunodeficiency virus infection

The otolaryngologist is uniquely positioned to detect and pursue manifestations of HIV in the head and neck. The presentation of problems subsequent to HIV infection is quite varied, but close investigation will often reveal treatable problems.

Common skin problems

Dermatological problems manifesting as primary and secondary cutaneous complaints, constitute at least 30% of all outpatient visits to a pediatrician and 30% of all visits to dermatologists involve patients of pediatric age group. There is, however, a paucity of data about pediatric dermatoses in India, which has been reviewed to the extent possible. A brief account of common dermatological problems in India mainly infestations (pediculosis capitis, scabies) and infections (pyoderma, molluscum contagiosum, warts, herpes simplex infection, varicella, herpes zoster, tinea capitis and corporis, tinea versicolor, and candidiasis) has been given. At the end, common pediatric dermatological emergencies have been short-listed. Erythema multiforme and its variants and acrodermatitis enteropathica are discussed briefly.

Psoriasis associated with human immunodeficiency virus in an infant

Psoriasis is commonly reported in association with HIV in adults. A 3-month-old girl with HIV presented with a widespread eruption and was diagnosed with psoriasis. This is the first infant reported with psoriasis in association with HIV infection. The relationship between the two entities is discussed, as is the role of treatment with zidovudine.

Neonatal disease induced by SIV infection of the rhesus monkey (Macaca mulatta)

Seven 72-hr-old Indian origin rhesus monkeys (Macaca mulatta) were inoculated with 10 animal ID50 of SIV/DeltaB670. Nine age-matched animals were used as uninoculated controls. All seven inoculated animals became infected as verified by viral isolation and SIV p26 antigenemia. Five of seven infected animals died within a mean of 31 days (range, 26-41 days), with high levels of antigenemia beginning 1-2 weeks postinoculation (PI) that persisted until death. Absolute lymphocyte numbers were within normal limits in all animals in both groups throughout the study. Inoculated animals that died within a mean of 31 days (short-term survivors) had significantly lower numbers of CD4+CD29+ (helper/inducer) lymphocytes than did long-term surviving inoculated animals through 3 weeks PI. Numbers of CD4+ lymphocytes were no different when controls were compared to all inoculated animals through 4-5 weeks PI. The two inoculated animals surviving 216 and 423 days PI (long-term survivors) did demonstrate declining CD4+ cells, but only late in disease. CD8+ lymphocytes were significantly lower in short-term survivors when compared to long-term survivors through 5 weeks PI. Antibody production against SIV viral proteins was detected only in the long-term survivors and was similar to results from past studies in juveniles. Clinical signs in the inoculated group were consistent with those seen in past studies on older animals. Persistent bacterial infections, primarily of the GI and respiratory tracts, were seen in the infected group. Aside from the lack of some opportunistic infections such as cytomegalovirus (CMV) and Pneumocystis carinii, necropsy findings were not different when compared to past studies on juvenile animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Pediatric infection with the human immunodeficiency virus (HIV): head, neck, and oral manifestations

The increasing incidence of HIV infection in the pediatric population is of concern for the practicing dentist. Long incubation periods of the virus, combined with difficulty in detection, results in many undiagnosed cases of prenatal and natal infections with HIV. As a result, many dentists will unknowingly treat HIV-positive children. This article presents most common features of pediatric HIV infection, placing special emphasis on manifestations which affect the head, neck, and oral tissues.

Scabies. How to find and stop the itch

Scabies is a pruritic skin infestation caused by the itch mite Sarcoptes scabiei. Physical proximity allows the mite to move from one host to another. The diagnosis is made by identifying the mite or its eggs or excrement microscopically from a sample of skin scrapings. Treatment is achieved with topical application of a scabicide and elimination of the mite from the patient's surroundings.