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M9460551.TXT
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1994-06-25
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Document 0551
DOCN M9460551
TI Photosensitivity as the presenting illness in four patients with human
immunodeficiency viral infection.
DT 9408
AU Pappert A; Grossman M; DeLeo V; Environmental Dermatology Unit,
Columbia-Presbyterian Medical; Center, New York, NY.
SO Arch Dermatol. 1994 May;130(5):618-23. Unique Identifier : AIDSLINE
MED/94234741
AB BACKGROUND: A multitude of skin lesions have been reported in
individuals with human immunodeficiency virus (HIV) infection. Some of
them, eg, severe seborrheic dermatitis and herpes zoster infections, may
predate the onset of the diagnostic criteria for the acquired
immunodeficiency syndrome and may actually raise the suspicion of HIV
infection in healthy-appearing individuals. We have recently evaluated
four individuals who presented with a severe idiopathic photosensitivity
of eczematous morphologic features who eventuated in a diagnosis of HIV
seropositivity. Four individuals who presented with an eczematous
eruption of sun-exposed skin were referred to the Environmental
Dermatology Unit of Columbia-Presbyterian Medical Center (New York, NY)
for evaluation of possible photosensitive disease. They were examined
and underwent photobiological testing (minimal erythema dose testing and
photopatch testing) to confirm and classify their suspected
photosensitivity. OBSERVATIONS: All four patients fulfilled the criteria
for chronic actinic dermatitis, a rare idiopathic photosensitivity
characterized by debilitating, unremitting dermatitis with eczematous or
lymphomalike histologic features and reproduction of lesions by small
quantities of mid-wave UV-B radiation (290 to 320 nm). All four
individuals were HIV seropositive and CD4 counts were markedly
suppressed in all four. The photosensitivity predated the finding of
seropositivity and the diagnosis of acquired immunodeficiency syndrome
in all four patients. CONCLUSION: The presentation of healthy-appearing
individuals with photodistributed dermatitis of unknown cause should
alert the physician to the possibility of HIV infection.
DE Adult Case Report Human HIV Infections/*COMPLICATIONS Male Middle
Age Photosensitivity Disorders/*COMPLICATIONS/DIAGNOSIS JOURNAL
ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).