AIDS and the dermatologist

Lymphangioma-like variant of Kaposi's sarcoma: clinicopathologic study of seven cases with review of the literature

The clinical and pathological features of seven cases of lymphangioma-like Kaposi's sarcoma (KS) are reported. As with the other subtypes of KS, the lymphangioma-like variant occurs more often in men aged 59-80 years. Clinically, the lesion appears intermingled with the classical forms of KS, but a "bulla-like" appearance recognized in seven of 13 cases has been considered as a clinical hallmark of this variant. Although occasional cases have shown aggressive behavior, the most frequent clinical course is slowly progressive with localized or diffuse involvement of lower limbs. The histological pattern, characterized by permeation of dermal collagen by labyrinthine vascular channels lined by a flattened endothelium, must be differentiated from spindle cell hemangioendothelioma, low-grade angiosarcoma, targetoid hemosiderotic hemangioma, and benign lymphangioendothelioma.

Characterization of circulating lymphocytes by monoclonal antibodies in childhood and adult leprosy

Peripheral blood lymphocyte assays using monoclonal antibodies were done in 66 patients with leprosy, consisting of 25 children and 41 adults. The results were statistically analyzed for correlations, if any, among the different age groups and matched controls. The results, however, failed to show any significant correlation, nor was it possible to draw any conclusion as to why the disease spectrum in children tends to be incomplete (ie, there is a low incidence of the highly bacilliferous form of disease expression).

Oral Kaposi's sarcoma in a woman as a first indication of HIV infection

Although Kaposi's sarcoma has been well described in homosexual men at risk for infection with the human immunodeficiency virus, there have been fewer reports of KS in women, and most of these have been in women who became infected with HIV through intravenous drug use. This report describes a woman who had no history of intravenous drug use in whom intraoral KS and hairy leukoplakia were the first indication of her infection with HIV.

Ectopic geographic tongue and AIDS

A 23-year-old man with AIDS developed a lesion with the clinical characteristics of an ectopic geographic tongue in the lower lip, near the right commissure.

Cutaneous manifestations of early human immunodeficiency virus exposure

After demonstrating antibodies to the human immunodeficiency virus (HIV), two hundred patients were interviewed and given a complete cutaneous and mucous membrane examination. By means of the Walter Reed Staging Classification System for HIV infection, 155 patients were classified as having Walter Reed stage 1A-2A (WR1A-WR2A) infection. The prevalence of seborrheic dermatitis in this group was 36%. There were no other significant cutaneous findings in the WR1A-WR2A patient population.

Clinical clues to AIDS. Recognizing the dermatologic and nondermatologic manifestations

As more types of human immunodeficiency virus (HIV) are recognized and as the incidence of acquired immunodeficiency syndrome (AIDS) increases, more and more manifestations of HIV infection will be recognized. Dermatologic conditions often provide a means of making the presumptive diagnosis. Months or years of asymptomatic disease may have elapsed before cutaneous symptoms appear. However, care must be taken not to over-diagnose on the basis of a single nonspecific finding. To say that all patients with psoriasis have AIDS, for example, would be absurd. Yet an explosive flare of psoriasis or an atypical new presentation should alert the clinician to the possibility of HIV infection. Certainly, multiple suggestive dermatologic findings in any patient would essentially confirm the diagnosis of AIDS regardless of the status of antibody reactivity. A wide range of nondermatologic physical findings can also signal HIV infection. None are specific for AIDS, but again, findings that are rare, atypical, or severe in a normal host should be viewed with suspicion, and any of the signs in an at-risk patient should prompt the clinician to consider AIDS and to include specific tests in the workup. By becoming familiar with the many faces of HIV infection, the clinician can recognize its varied manifestations that may suggest the diagnosis in the absence of other findings.