Skin Diseases Remain Common in Older Adults With HIV

syphilis rash on hands
syphilis rash on hands
Cutaneous manifestations are frequently associated with immune dysfunction in HIV.

This article is part of Infectious Disease Advisor’s in-depth coverage of IDWeek 2017™, which took place in San Diego, CA. Our staff will be reporting on the latest treatment advancements and research initiatives for skin infections. Check back regularly for highlights from IDWeek 2017.

Skin conditions, including syphilis, actinic keratosis, seborrheic dermatitis, and onychomycosis, remain common in patients with HIV who are older than 50, according to recent research presented at IDWeek 2017, held October 4-8 in San Diego, California.

In this retrospective cohort study, 381 veterans older than 50 with HIV (mean [SD] age 59.95 [7.41]; median CD4 T-cell count 446 cell/mm3) were evaluated for cutaneous pathologies occurring in 2015. The diagnoses made by infectious disease physicians were compared with diagnoses made by dermatologists.

In 2015, 558 dermatological diagnoses were made in 241 patients; 172 of these were new diagnoses. 

The most common cutaneous pathologies were syphilis (5.39%), actinic keratosis (4.98%), seborrheic keratosis (4.56%), seborrheic dermatitis (4.56%), and onychomycosis (3.73%).

When AIDS-defining cutaneous pathologies were analyzed, the researchers found fewer recent cases of cryptococcosis, chronic herpes simplex, histoplasmosis, and Kaposi sarcoma compared with remote cases.

Dermatologists agreed with the diagnosis of the referring infectious disease provider in 57.9% (n=22/38) of cases.

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The study investigators concluded that “dermatologic manifestations continue to be common in our aging HIV seropositive population. The most common diagnosis was syphilis, reflecting an ongoing epidemic of this disease in this population, followed by more common diagnoses of actinic keratosis, seborrheic keratosis, seborrheic dermatitis and onychomycosis.”

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Tracy A, O’Neill S, Cadena J, Kowalewski C, Walter E. Cutaneous diseases among an aging HIV cohort, receiving care at an infectious diseases/primary clinic. Presented at: IDWeek 2017; October 4-8, 2017; San Diego, California. Poster 565.