Skin disorders in Korean patients infected with human immunodeficiency virus and their association with a CD4 lymphocyte count: A preliminary study

Background: Dermatological disorders are quite common in human immunodeficiency virus (HIV)-infected patients. However, cutaneous findings in Korean HIV-infected patients have not been properly investigated. Objective: To investigate the spectrum of dermatological disorders in Korean HIV-infected individuals according to a CD4 lymphocyte count. Methods: A retrospective clinical study was carried out from June 2002 to January 2008. We comprehensively collected information regarding HIV-associated skin problems, laboratory data and the history of highly active antiretroviral therapy (HAART). Results: Ninety-nine HIV-seropositive patients (mean age: 39.6 ± 11.3 years, males: 94.9%) were included in this study. Of them, 55 patients (55.6%) presented with at least one skin problem. The four most common dermatological disorders were eosinophilic pustular folliculitis (18.6%), symptomatic syphilis (comprising of primary and secondary syphilis) (17.1%), seborrhoeic dermatitis (17.1%) and condyloma acuminatum (12.8%). The group with a CD4 lymphocyte count < 200 × 10⁶ cells/L showed a significantly higher prevalence of Kaposi sarcoma compared with the group with a CD4 lymphocyte count > 200 × 10⁶ cells/L (P = 0.014). Condyloma was more prevalent in the group with a CD4 count > 200 × 10⁶ cells/L (P = 0.022). The patients treated with HAART had a lower prevalence of neurosyphilis compared with the non-treated group (P = 0.018). Conclusions: Diverse dermatological conditions were demonstrated in Korean HIV-infected patients. Kaposi sarcoma was associated with a low CD4 lymphocyte count, but condyloma was associated with a high CD4 lymphocyte count. The prevalence of syphilis in our study was higher than that of Western countries. HAART seemed to be associated with the low prevalence of neurosyphilis.