Cutaneous Manifestations of Human Immunodeficiency Virus/AIDS Patients in Albania

CONTEXT

Dermatologic diseases are common in the human immunodeficiency virus (HIV)-infected population. Cutaneous manifestations of HIV disease may result from HIV infection itself or from opportunistic disorders secondary to the declined immunocompetence due to the disease.

AIMS

The aim of this study is to determine the pattern of c0utaneous manifestations in HIV in an adult HIV Clinic in Tirana.

SUBJECTS AND METHODS

This is a retrospective study including 355 HIV-positive patients with cutaneous manifestations who referred to the Ambulatory Clinic for HIV/AIDS, at the Infective Service and Dermatology Service of University Hospital Centre "Mother Theresa," Tirana, Albania over the period 2008-2015.

RESULTS

The mean age of patients was 43.08 (±11.8) years, with a range 15-79 years. Two hundred and forty-seven (69.6%) of patients were male and 108 (30.4%) female. Male-to-female ratio is 2.3:1. The study found a significant trend of increasing incidence of dermatological pathologies with increasing stage of the disease. Fifty-five (15.5%) of patients with cutaneous lesions were in Stage 1, 132 (37.2%) in Stage 2, and 168 (47.4%) in Stage 3 (P < 0.001). As for the HIV transmission method, the majority of patients (71%) were infected through heterosexual contact, followed by homosexual contact (16.3%), blood transfusion (3.4%), injecting drug user (2.3%), while for 7% of patients the mode of transmission was unknown.

CONCLUSIONS

Early recognition of the cutaneous manifestation can help in better management of HIV infection in resource-poor setting, as it can indicate the progression of the disease and underlying immune status.

The use of patch testing for the diagnosis of contact dermatitis: an Albanian experience

Introduction: The daily increase of using chemical, aromatic and cosmetic products has been associated with significant increase in frequency of skin diseases such as eczemas and contact dermatitis (CD). The aim of this study was to evaluate the use of patch testing (PT) for the diagnosis of CD and provide current data on the frequency of sensitization to various contact allergens among patients with CD in the Albanian population.Methods: We retrospectively analyzed all consecutive patients clinically suspected for CD during the period February 2010 – February 2011, in the outpatient setting. PT was done using Baseline European Series consisting of 31 allergens. Risk factors (age, gender, occupation and place of residence) and sensitization to various contact allergens were evaluated.  Results: In total, 193 patients clinically suspected for CD were included in the study and underwent PT. The highest prevalence of CD was found in the age-group of 31-40 years (32.6%), with a statistically significant difference between other age-groups (X2 = 141.2, p<0.01). Positive PT results with at least one allergen were seen in 144 (74.6 %) patients suspected for CD. The two most common allergens were nickel and potassium dichromate. Construction worker and hairdresser were the most affected professions. Females had a chance of 1.8 times higher for having a positive patch test result compare to males (OR = 1.8; 95% CI 0.91 – 3.39).Conclusion: Determination of allergens that cause contact dermatitis is a necessity not only to confirm the correct diagnosis, but also for the qualitative treatment and prevention of the disease. Patch testing, even though an old method, still remain a valuable and non-invasive approach to determine the causes of contact dermatitis.

Multiple ulcers in primary syphilis with negative rapid plasma reagin and Venereal Disease Research Laboratory tests: an unusual presentation during the re-emergence of syphilis in Albania

Since 1995 infectious syphilis has re-emerged in Albania. As syphilis has become more common, more unusual presentations are being recognized. We present a case of an HIV-negative man with primary syphilis presenting with multiple penile ulcers and negative rapid plasma reagin and Venereal Disease Research Laboratory tests. The case illustrates the challenges of diagnosing early syphilis and the importance of not relying on non-treponemal tests.