Paediatric HIV-related skin diseases.pdf

Mini-SyMpoSiuM: HiV/AiDS-ASSociAteD pAtHology in cHilDrenPaediatric HIV-related skin diseases Wayne grayson Abstract Mucocutaneous lesions are a frequent manifestation of human immu- nodeficiency virus (HiV) infection and/or the acquired immunodeficiency syndrome (AiDS) in adult and paediatric patients alike. these include a wide variety of infective disorders, inflammatory dermatoses and adverse drug reactions. Although there is considerable overlap in the spectrum of skin disease in both groups, significant differences exist. oral candidiasis, which implies marked immune deficiency in adults with AiDS, may occur without severe cD4+ t-cell depletion in children. infec- tive and inflammatory disorders such as oral hairy leucoplakia, bacillary angiomatosis and HiV-associated eosinophilic pustular folliculitis are exceedingly uncommon in children. Kaposi sarcoma is encountered far less frequently in children, and non-Hodgkin lymphoma in mucocutane- ous sites is rarely seen. Stigmata of concomitant nutritional deficiencies are often observed in children. this review gives an overview of this spectrum of disease. the paucity of literature on the immune reconstitu- tion inflammatory syndrome in the paediatric context is emphasized. Keywords acquired immunodeficiency syndrome; AiDS; children; HiV; human immunodeficiency virus; skin Introduction According to the 2008 UNAIDS survey, the number of children younger than 15 years living with human immunodeficiency virus (HIV) infection in 2007 increased from 1.6 million to an estimated 2.0 million worldwide.1 It is estimated that during 2007 alone, between 330,000 and 410,000 children became infected with HIV, and that 270,000 HIV-infected children succumbed to acquired immunoeficiency syndrome (AIDS).1 The overwhelm- ing majority of new infections in the paediatric population are acquired as a result of vertical transmission during pregnancy, birth or breastfeeding; in only a small percentage of cases