PMID- 19874370
OWN - NLM
STAT- MEDLINE
DCOM- 20110103
LR  - 20220310
IS  - 1365-2230 (Electronic)
IS  - 0307-6938 (Linking)
VI  - 35
IP  - 5
DP  - 2010 Jul
TI  - Immune reconstitution inflammatory syndrome involving the skin.
PG  - 477-81
LID - 10.1111/j.1365-2230.2009.03620.x [doi]
AB  - BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS) occurs in 10-25% 
      of unselected patients starting highly active antiretroviral therapy (HAART). 
      About 52-78% of these cases involve cutaneous features. AIM: To describe the 
      prevalence and incidence of new dermatological conditions within 6 months of 
      patients starting HAART, and to specify the clinical and immunological features 
      and time of onset in patients responding to HAART. METHODS: A retrospective 
      cohort analysis was performed of 59 treatment-naive patients started on HAART and 
      followed up for 6 months by a clinician trained in dermatology. Medical records 
      were reviewed for new dermatological conditions diagnosed clinically. RESULTS: In 
      all, 30 patients (50.8%) developed 45 new skin conditions at a median of 8 weeks 
      (range 3-24 weeks) after starting HAART. The incidence rate was 104.5 cases per 
      100 patient-years. Diagnoses included seborrhoeic dermatitis (nine patients), 
      anogenital herpes (seven patients), acne, tinea and folliculitis (six patients 
      each), Kaposi's sarcoma, herpes zoster, genital warts and eczema (two patients 
      each), and molluscum contagiosum, planar warts and pityriasis versicolor (one 
      patient each). Significantly more women (23/38; 60.5%) than men (7/21; 33.3%) (P 
      < 0.05) developed new skin lesions after starting HAART. Baseline median CD4 
      counts in those with and without IRIS were 60/microL and 62/microL, respectively, 
      and in both groups, the counts increased to > 90/microL by week 12. Baseline 
      median viral load was > 100,000 copies/mL and was < or = 32 copies/mL by week 12. 
      In both groups, the majority of patients were in World Health Organization stages 
      3 and 4. CONCLUSIONS: New skin lesions were very common in this cohort, with the 
      majority being women and patients with very low baseline CD4 counts.
FAU - Osei-Sekyere, B
AU  - Osei-Sekyere B
AD  - Department of Medicine, Chris Hani Baragwanath Hospital and University of 
      Witwatersrand, Johannesburg, South Africa.
FAU - Karstaedt, A S
AU  - Karstaedt AS
LA  - eng
PT  - Journal Article
DEP - 20091023
PL  - England
TA  - Clin Exp Dermatol
JT  - Clinical and experimental dermatology
JID - 7606847
SB  - IM
MH  - Adult
MH  - Antiretroviral Therapy, Highly Active/*adverse effects
MH  - CD4 Lymphocyte Count
MH  - Cohort Studies
MH  - Female
MH  - Follow-Up Studies
MH  - HIV Infections/*drug therapy
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*chemically induced
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Skin Diseases/*chemically induced
MH  - South Africa
MH  - Time Factors
MH  - Young Adult
EDAT- 2009/10/31 06:00
MHDA- 2011/01/05 06:00
CRDT- 2009/10/31 06:00
PHST- 2009/10/31 06:00 [entrez]
PHST- 2009/10/31 06:00 [pubmed]
PHST- 2011/01/05 06:00 [medline]
AID - CED3620 [pii]
AID - 10.1111/j.1365-2230.2009.03620.x [doi]
PST - ppublish
SO  - Clin Exp Dermatol. 2010 Jul;35(5):477-81. doi: 10.1111/j.1365-2230.2009.03620.x. 
      Epub 2009 Oct 23.