Trends in rifampicin resistance among patients with presumptive TB in the pre-COVID and COVID-era.

Background: The COVID 19 pandemic has had its impact on tuberculosis notification, incidence, and management, particularly in the context of rifampicin-resistant TB. We set out to determine the trends in rifampicin resistant tuberculosis between the pre-COVID and COVID era in a resource-constrained setting. Methods: This was a retrospective review of single early morning sputum from presumed tuberculosis between January 2016 and May 2022 in a regional TB referral and treatment centre in South-western, Nigeria. We used a molecular beacon to detect Mycobacterium tuberculosis (MTB) and mutations in the rpoB gene using a real-time polymerase chain reaction (PCR). Results: We analyzed 19,892 of 20,589 presumptive TB with complete data. Most subjects were in the age group 18-45 years (10,594; 53.3 %) and were males (11,492; 57.8 %). Of the 19,892 presumptive TB, 4,526 (22.8 %) were in pre-COVID-19 era (Jan 2016-December 2019) and 15,366 (77.2 %) cases were in COVID-19 era (Jan 2020-May 2022). The MTB notification declined during the COVID-19 era compared with the pre-COVID-19 era (10.5 % vs 12.9 %, p < 0.001). The annual prevalence of MTB rose from 5.6 % (2016) to a peak of 23.2 % in 2019 (pre-COVID-19 era), followed by a decline to 12.8 % in 2020 and 8.6 % in 2022 (COVID-19 era), p = <0.001). The overall incidence of RR-TB was 3.8 %. The incidence of RR was higher during pre-COVID-19 than the COVID-19 era, 9.5 % vs 2.5 %, p = <0.001. The incidence of RR-TB declined substantially from 28.0 % in 2016 to 1.6 % in 2021 but rose exponentially to 5.4 % in 2022. After controlling for confounders, only the pre-COVID-19 status was associated with increased odds for RR (adjusted odds ratio 3.3, 95 % confidence interval, 2.049, 5.421). Conclusion: This study found a progressive decline in MTB notification since the COVID-19 pandemic's outbreak. Furthermore, RR-TB notification decreased gradually in the pre-COVID-19 era, with a resurgence in 2022. In the era of COVID-19, there is an urgent need to increase intervention efforts in order to halt the decline in MTB detection rates and the resurgence of RR-TB.

Apoprotein L1 risk variants and kidney transplantation: a protocol for systematic review and meta-analysis.

Graft survival after kidney transplantation may be influenced by both donors' and recipients' Apoprotein 1 (APOL1) risk variant status. There are several conflicting reports on screening, eligibility, and inclusion of APOL1 risk variant testing in the Kidney donor risk index. We developed a search strategy that included medical subject headings (MeSH), text words, and entry terms in order to search nine databases. The primary measurable outcome is the recipient's post-transplant graft survival time from APOL1 high-risk variant donors. The secondary outcomes are the proportion of APOL1 high-risk variants in end-stage kidney disease requiring a kidney transplant, the proportion in graft recipients and kidney donors; the effect of APOL1 high-risk variant on donor's kidney function post-kidney donation, recipient kidney allograft survival in APOL1 low and high-risk recipients. Confidence and comprehensive meta-analysis software will be used for the meta-analysis. Methodological, clinical, and statistical heterogeneity will be assessed. Publication bias will be visually assessed using the funnel plot. Results will be presented in forest plots with pooled survival time, standard error, and variance. Sub-group analysis will be performed using moderators such as sociodemographic characteristics, hypertension, HIV status, forms of rejection and other environmental factors. The primary outcome effect size is the standardized mean difference in survival time for APOL1 high risk variants in kidney transplants. The differences in kidney function between donors and recipients before and after transplantation would be examined. The suitability of donors with APOL1 high risk variants will be explored in terms of graft survival time, donor kidney function, and the aforementioned moderators.

Body dysmorphic disorder in patients attending a dermatology clinic in Nigeria: sociodemographic and clinical correlates.

BACKGROUND: Body dysmorphic disorder is a relatively common psychiatric disorder in the context of dermatology and cosmetic and plastic surgery but is underdiagnosed and underreported in Africa. OBJECTIVE: To evaluate the prevalence of body dysmorphic disorder and symptoms of anxiety/depression and determine their sociodemographic and clinical correlates. METHODS: A systematic random sampling design was made to recruit 114 patients with skin diseases. Sociodemographic and clinical data were obtained. The Body Dysmorphic Disorder Modification of the Yale-Brown Obsessive-Compulsive Scale, Hospital Anxiety and Depression Scale was administered, and data were analyzed using SPSS 20. RESULTS: Mean age of participants was 37.70±17.47 years, and 67/114 (58.8%) were females. Prevalence of body dysmorphic disorder was 41/114 (36.0%), and prevalence of anxiety/depression symptoms was 35/114 (30.7%). Prevalence of body dysmorphic disorder in patients with anxiety/depression symptoms was 15/41 (36.6%), and patients with facial disorders expressed the highest burden of anxiety/depression symptoms, in 15/35 (42.9%). Factors associated with significantly higher mean body dysmorphic disorder include age<50years (p=0.039), and anxiety/depression (p<0.001), education below high school was associated with higher mean anxiety/depression score (P= 0.031). In a binary logistic regression model, presence of anxiety/depression symptoms was predictive of body dysmorphic disorder (OR=10.0, CI: 4.1-28.2, p<0.001). STUDY LIMITATIONS: the study is uncontrolled, conducted in a single source of care, thus limiting generalization to nonrelated settings. CONCLUSION: Prevalence of body dysmorphic disorder is high among dermatology patients and most prevalent in facial disorders. Facial diseases are associated with the highest burden of anxiety/depression symptoms. This is a clarion call for dermatologists to routinely assess for body dysmorphic disorder and appropriately refer affected patients to mental health care.

Metabolic Syndrome and Dyslipidemia among Nigerians with Lichen Planus: A Cross-Sectional Study.

BACKGROUND: Lichen planus (LP) is an inflammatory skin disease of unknown etiology associated with chronic inflammation, oxidative stress induction, and cardiovascular risk factors. OBJECTIVES: To document the prevalence of metabolic syndrome (MetS), dyslipidemia, and associated factors in Nigerian patients with LP. METHODS: A cross-sectional design was made to evaluate 90 patients with LP and 90 controls for MetS and dyslipidemia in two Nigerian teaching hospitals. Diagnosis of LP was made with the aid of histology, and MetS and dyslipidemia were diagnosed using the National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS: The prevalence of MetS was insignificantly higher in LP than in control (18.9% vs. 13.5, P = 0.311), and dyslipidemia was significantly associated with LP (60% vs. 40%, P = 0.007). LP was associated with higher mean of serum triglyceride (1.21 ± 0.34 vs. 1.08 ± 0.32 mmol/L, P = 0.003), low-density lipoprotein cholesterol (3.47 ± 0.89 vs. 3.12 ± 0.77 mmol/L, P = 0.007), and T-cholesterol (5.32 ± 0.88 vs. 4.92 ± 0.86, P = 0.002). LP patients with MetS were older (P < 0.001) and less likely to have Wickham's striae (P = 0.028) compared to those without MetS. Female LP patients were older (P = 0.047), obese (P = 0.043), and had insignificant increase in MetS prevalence compared to the males. Hypertrophic LP was more frequent in patients with dyslipidemia (63.0% vs. 27.8%, P = 0.002), and the family history of diabetes mellitus (DM) was an independent predictor of MetS in LP patients (odds ratio: 4.4, confidence interval: 1.0-19.1, P = 0.047). LIMITATION: Availability of fund is a significant factor that limited the sample size to the minimum required as always in a poor-resource setting. CONCLUSIONS: LP has an insignificant association with MetS and a significant association with dyslipidemia among Nigerians. The family history of DM is an independent predictor of MetS in LP patients. LP patients should be routinely screened for MetS and its components.

Assessment of HIV-related stigma and determinants among people living with HIV/AIDS in Abeokuta, Nigeria: A cross-sectional study.

INTRODUCTION: HIV/AIDS-related stigma remains an essential barrier to the formulated care delivery and improved quality of life of people living with HIV/AIDS in sub-Saharan Africa. Only a few studies have evaluated stigma and its determinants as concerns people living with HIV/AIDS in Nigeria. METHODS: A cross-sectional design study recruited 386 people living with HIV/AIDS attending the government clinic, Federal Medical Centre, Abeokuta, Nigeria, for the assessment of stigma using Berger's HIV stigma scale and United States Agency International Development-recommended indicators and questions on HIV-related stigma among people living with HIV/AIDS. Data were analyzed using SPSS 21. RESULTS: Of the 386 people living with HIV/AIDS, 322 (83.4%) were females and 64 (16.6%) were males, and 96.9% had disclosed their HIV status. Overall, mean perceived stigma score was moderately high at 95.74 (standard deviation = ±16.04). Majority (77.2%) of the participants experienced moderately perceived stigma. Among the subscales, disclosure concerns contributed the most to stigma score at 68.9%. Enacted stigma in the last 12 months was documented in 35.8% (138). There was no association observed between age, gender, marital status and HIV-related stigma. However, low education was associated with higher negative self-image perception (31.83 ± 5.81 vs 29.76 ± 5.74, p < 0.001). Furthermore, higher perceived stigma score was associated with abandonment by spouses (p < 0.001), isolation from household members (p < 0.001) and social exclusion (p < 0.001). We demonstrated a correlation between the domains of enacted stigma and Berger HIV stigma scales except for the loss of resources. CONCLUSION: Perceived HIV-related stigma is moderately high among people living with HIV/AIDS. Low education, disclosure concerns, spousal or household abandonment and social exclusion are the significant contributors. HIV-related stigma preventive interventions at different levels of care are advocated.

Body dysmorphic disorder in patients attending a dermatology clinic in Nigeria: sociodemographic and clinical correlates

Abstract: Background: Body dysmorphic disorder is a relatively common psychiatric disorder in the context of dermatology and cosmetic and plastic surgery but is underdiagnosed and underreported in Africa. Objective: To evaluate the prevalence of body dysmorphic disorder and symptoms of anxiety/depression and determine their sociodemographic and clinical correlates. Methods: A systematic random sampling design was made to recruit 114 patients with skin diseases. Sociodemographic and clinical data were obtained. The Body Dysmorphic Disorder Modification of the Yale-Brown Obsessive-Compulsive Scale, Hospital Anxiety and Depression Scale was administered, and data were analyzed using SPSS 20. Results: Mean age of participants was 37.70±17.47 years, and 67/114 (58.8%) were females. Prevalence of body dysmorphic disorder was 41/114 (36.0%), and prevalence of anxiety/depression symptoms was 35/114 (30.7%). Prevalence of body dysmorphic disorder in patients with anxiety/depression symptoms was 15/41 (36.6%), and patients with facial disorders expressed the highest burden of anxiety/depression symptoms, in 15/35 (42.9%). Factors associated with significantly higher mean body dysmorphic disorder include age<50years (p=0.039), and anxiety/depression (p<0.001), education below high school was associated with higher mean anxiety/depression score (P= 0.031). In a binary logistic regression model, presence of anxiety/depression symptoms was predictive of body dysmorphic disorder (OR=10.0, CI: 4.1-28.2, p<0.001). Study limitations: the study is uncontrolled, conducted in a single source of care, thus limiting generalization to nonrelated settings. Conclusion: Prevalence of body dysmorphic disorder is high among dermatology patients and most prevalent in facial disorders. Facial diseases are associated with the highest burden of anxiety/depression symptoms. This is a clarion call for dermatologists to routinely assess for body dysmorphic disorder and appropriately refer affected patients to mental health care.

Idiopathic scrotal calcinosis: report of 2 cases, and review of pathogenesis and factors that determine patients' acceptance of surgical treatment.

INTRODUCTION: Idiopathic scrotal calcinosis is a benign and rare disease of the scrotal skin that presents as solitary or multiple asymptomatic calcified nodules in the absence of systemic disorders of calcium/phosphorus balance. CASE REPORTS: We report the management of 2 cases and review the literature with comments on factors that determine acceptance or otherwise of surgical treatment. Our patients were 29 and 33 years old and presented with nodular scrotal lesions. Through multiple elliptical incisions, all nodules were excised from patient 1, but patient 2 refused surgery. Reasons for rejection included fear of future reproductive performances. Histology shows calcium deposition in basophilic globules of varying sizes and shapes within the reticular dermis, multinucleated giant cells, dense collagenous stroma, areas of fibrosis, and sparse lymphocytic infiltrate. CONCLUSION: In the management of idiopathic scrotal calcinosis, factors that determine acceptance of surgical treatment could include impaired quality of life, reduced self-esteem, fear of future sexual dysfunction, and development of complications.

The impact of acne and facial post-inflammatory hyperpigmentation on quality of life and self-esteem of newly admitted Nigerian undergraduates.

BACKGROUND: Acne and facial post-inflammatory hyperpigmentation are relatively common clinical conditions among adolescents and young adults, and inflict psychosocial injuries on sufferers. OBJECTIVE: To document the psychosocial and self-esteem implications of acne and facial hyperpigmentation on newly admitted undergraduates. MATERIALS AND METHODS: A cross-sectional survey was conducted among 200 undergraduates. Demographics and clinical characteristics were obtained and acne was graded using the US Food and Drug Administration 5-category global system of acne classification. Participants completed the Cardiff Acne Disability Index (CADI) and the Rosenberg self-esteem scale (RSES), and data were analyzed using SPSS 20. RESULTS: Mean age of acne onset was 16.24 ± 3.32 years. There were 168 (84.0%) cases categorized as almost clear, 24 (12.0%) as mild acne, 4 (2.0%) as moderate acne and 4 (2.0%) as severe acne. Acne with facial hyperpigmentation, compared to acne without hyperpigmentation, was associated with significant level of anxiety in 30 participants (26.5% vs 10.3%, p=0.004) and emotional distress in 40 (35.4% vs 10.3%, p<0.001). Acne severity correlated with total CADI score but not with total RSES score. Quality of life (QoL) was significantly reduced among acne patients with facial hyperpigmentation (1.77±1.62, vs 1.07±1.02, p<0.001) compared to those without hyperpigmentation. Acne and facial hyperpigmentation was associated with social life interference, avoidance of public facilities, poor body image and self-esteem and perception of worse disease. There was no association between gender and QoL but acne was related to a reduction of self-worth. Low self-esteem was present in 1.5%, and severe acne was associated with an occasional feeling of uselessness in the male gender. CONCLUSION: Acne with facial hyperpigmentation induces poorer QoL and self-esteem is impaired only in severe acne. Beyond the medical treatment of acne, dermatologists should routinely assess the QoL and give attention to treatment of facial post-inflammatory hyperpigmentation among people of color.

Patients' feelings about the presence of medical students in a New Teaching Hospital in Southwestern Nigeria.

BACKGROUND: This study aimed to evaluate how patients feel about the introduction of medical students into a former general hospital transformed to a teaching hospital in southwestern Nigeria and to also assess the extent to which they are willing to involve medical students in the management of their conditions. METHODS: In a descriptive cross-sectional study, a sample of 251 randomly selected patients were interviewed using a pretested questionnaire that assessed patients' demography, patients' acceptance of and reaction to the involvement of medical students in their clinical care including the specific procedures the patients would allow medical students to perform. RESULTS: Two hundred and fifty-one patients with mean age ± standard deviation of 37.33 ± 19.01 (age range = 16-120 years; M:F = 1:1.26) were recruited between January 01 and March 31, 2013. Most patients (86.5%) preferred to be treated in a teaching hospital and were comfortable with medical students as observers (83.7%) and serving as the doctors' assistant (83.3%) during common diagnostic procedures. Men were more willing to have invasive procedures such as insertion of urinary catheter (56.6% vs. 43.4%, P = 0.001). Acceptability of medical students (such as willingness of patients to have students read their medical notes) was significantly higher in nonsurgical specialties than in surgical specialties (77.5% vs. 22.5%, P< 0.001). Factors associated with a positive disposition include age> 40 years, male gender, and higher level of education as well as consultation in nonsurgical specialties (P = 0.001). DISCUSSION: Medical students are well received into this new teaching hospital setting. However, there is a need for more education of younger, less educated female patients of surgical subspecialties so that they can understand their importance as irreplaceable partners in the training of medical students.

The Prevalence, Risk Factors and Changes in Symptoms of Self Reported Asthma, Rhinitis and Eczema Among Pregnant Women in Ogbomoso, Nigeria.

BACKGROUND: Allergic disorders have become a major public health concern worldwide. No Nigerian study has examined the epidemiology of allergic diseases among women. AIM: To document the prevalence, risk factors and the changes in the symptoms of allergic disorders during pregnancy. SETTINGS AND DESIGN: Cross-sectional study conducted at the booking and antenatal clinics of LAUTECH Teaching Hospital and Millennium Development Goals (MDG) Clinic of the Comprehensive Health Center, Oja Igbo, Ogbomoso, Nigeria. MATERIALS AND METHODS: Study enrolled 432 women from two public hospitals. Sociodemographic and clinical history were obtained and allergic disorders were diagnosed using ISAAC questionnaires. RESULTS: The prevalence of wheezing, eczema and rhinitis in pregnancy are 7.5%, 4.0% and 5.8% respectively. The prevalence of wheezing and eczema was slightly higher among the pregnant in past 12 months. Wheeze worsened in 70% (18/26), improved in 15% (2/26), and stable in 15% (2/26). Eczema worsened in 50% (7/14), improved in 7.1% (1/14) and stable in 42.9% (6/14), while allergic rhinitis worsened in 50% (11/22), improved in 22.7% (5/22) and stabilized in 27.3 % (6/22). In multivariate analysis, the risk of allergic diseases in pregnancy was increase 2 times by low income earning (CI: 1.2 - 2.1, p = 0.002), low level education (OR = 0.6, CI: 0.3 - 0.9, p = 0.011) and by family history of asthma, OR-4.3, CI - 1.3 - 13.9, p = 0.015. Family history of asthma increase the chances of asthma by 18.7 times, CI-2.3 - 152.2, p = 0.006, while the odd of eczema was increased 9.1 times (CI-2.7 - 30.6, p<0.001) and 2.4 times (CI: 1.2 - 4.7, p = 0.008) by second hand home smoking and low-family income respectively. The risk of allergic rhinitis were raised 1.8 times by low family income (CI 1.1 - 2.8, p = 0.013) and 3.9 times by family history of rhinitis (OR = 3.9, CI 1.2 - 12.7, p = 0.024). CONCLUSION: Prevalence of wheezing and eczema are higher in pregnancy probably due to exacerbation induced by pregnancy. Social and genetic factors are important risk factors for allergic disorders in pregnancy.

Quality of life of Nigerians living with human immunodeficiency virus.

INTRODUCTION: Few reports from Nigeria have examined the quality of life (QOL) of people living with HIV/AIDS (PLWHA) despite the fact that Nigeria has the second largest number of PLWHA in the world. This study evaluated the QOL of Nigerians living with HIV/AIDS using the World Health Organization Quality of Life Questionnaire for HIV-Brief Version (WHOQOL-BREF) instrument and assessed the impact of demographic, laboratory and disease-related variables on QOL. METHODS: This cross-sectional study involved 491 consecutive PLWHA aged ≥ 18 years attending the dedicated clinic to PLWHA in South-west Nigeria. RESULTS: The lowest mean QOL scores were recorded in the environment and social domains. Participants aged ≥ 40 years had better QOL in the environment (p = 0.039) and spirituality (p = 0.033) domains and those in relationships had better QOL in the social relationship domain (p = 0.002). Subjects with no or primary education and those who rated their health status as good gave significantly higher ratings in all QOL domains. Participants with AIDS had significant lower QOL in the level of independence domain (p = 0.018) and those with CD4 count ≥ 350 cells /mm3 had better QOL scores in the physical, psychological and level of independence domains. Subjects without tuberculosis co-infection and those on antiretroviral therapy (ART) reported significantly better QOL in the physical, psychological, level of independence and spirituality domains. CONCLUSION: Marital relationship, absence of tuberculosis, CD4 count ≥ 350 cells /mm3 and use of ART positively impacted QOL of our patients.

Frequency, pattern, and extent of skin diseases in relation to CD4+ cell count among adults with human immunodeficiency virus infection or acquired immunodeficiency syndrome in Osogbo, southwestern Nigeria.

BACKGROUND: Skin diseases characterize all stages of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) and contribute significantly to associated morbidity and mortality. OBJECTIVES: The aim of this study was to document the prevalences, patterns, and extents (severity) of skin diseases and their relationships with immunologic status in HIV/AIDS patients. METHODS: A total of 140 HIV/AIDS patients in different stages of HIV infection and 140 controls were recruited. Skin diseases were documented and CD4+ cell counts determined in all subjects. Severity was assessed according to the body surface area affected (using the Wallace rule of nines and the rule of palm) for lesions that tended to be widespread. The number of digits involved was counted for lesions involving the nails. Intensity of pain was graded for specific conditions such as herpes zoster. Chi-squared statistics and Pearson correlations were determined. RESULTS: Mean±standard deviation age was 35.04±8.83 years in the patient group and 32.21±8.30 years in the control group. The prevalences and patterns of skin diseases in HIV/AIDS patients were similar to those reported in previous studies. Most commonly found dermatoses were oral candidiasis (n=28, 20.0%), pruritic papular eruption (n=27, 19.3%), xeroderma (n=23, 16.4%), dermatophytosis (n=22, 15.7%), and fluffy hair (n=19, 13.6%). The presence of specific skin lesions represented a better correlate with immunosuppression than cutaneous extents. However, the extents of viral warts and multiple blue­black nails correlated significantly with CD4+ cell count. The presence of a lighter hair color phenotype signifies a lower CD4+ cell count than a softer hair phenotype. CONCLUSIONS: The presence of specific skin lesions correlates more strongly with a low CD4+ cell count than does the extent of their distribution, except in cases of viral warts. The presence of and higher numbers of nails affected with blue­black nail hyperpigmentation suggest severe immunosuppression.

The impacts of first line highly active antiretroviral therapy on serum selenium, CD4 count and body mass index: a cross sectional and short prospective study.

INTRODUCTION: The relationship that exists between body weights, serum selenium and immunological markers of HIV/AIDS continue to provoke more researches in the recent times. The objectives of this study were to examine baseline body mass index, CD4 count and serum selenium and to prospectively assess the impacts of HAART on same parameters 48 weeks post HAART among HIV patients. METHODS: A cohort comprising 140 newly diagnosed HIV positive were prospectively studied. Anthropometric measurements, serum selenium and CD4 count were assessed at diagnosis and 48 weeks post HAART. RESULTS: The mean age for patients was 35±8.8 years; 68% was female. Patients' mean weight was 56.79±10.22kg, BMI; 21.59±3.53, serum selenium; 0.55 ± 0.45µmol/L and CD4 count; 288.36 ± 232.23 at the baseline. At diagnosis, 47 (33.6%) were in stage 1, 49 (35.0%) in stage 2, 26 (18.6%) and 18 (12.9%) were in stage 3 and 4 respectively. Similarly, most patients had normal body mass index, 94 (67.14%), 26 (18.57%) were underweight, (12.86%) were overweight and two (1.43%) were obese at diagnosis. At 48 weeks post HAART, the mean weight, BMI, serum selenium and CD4 count were significantly increased. CONCLUSION: HAART repleted CD4 count and serum selenium, Post HAART overweight was associated with lesser CD4 count reconstitution and selenium repletion. A renew call for weight monitoring in HAART era.

Serum selenium and skin diseases among Nigerians with human immunodeficiency virus/acquired immune deficiency syndrome.

BACKGROUND: The role of selenium as an antioxidant micronutrient has garnered the unprecedented focus of researchers in recent times. No clinical study has related serum selenium concentration to skin diseases in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients. METHODS: In this study, 134 newly diagnosed HIV patients that satisfied the inclusion criteria were included. Skin diseases were clinically diagnosed and fasting venous blood was taken for assessment of serum selenium using an atomic absorption spectrophotometer. RESULTS: THE MEAN AGE OF HIV SUBJECTS WITH AND WITHOUT SKIN DISEASE WERE NOT SIGNIFICANTLY DIFFERENT: 32.72 ± 9.21 versus 35.86 ± 8.55 years, P = 0.077, respectively. The mean of serum selenium (0.51 ± 0.48 versus 0.81 ± 0.39), CD4+ count (228.06 ± 212.89 versus 446.41 ± 182.87), and body mass index (BMI; 21.09 ± 3.58 versus 23.53 ± 3.35) were significantly lower (P < 0.001) for HIV/AIDS participants with skin disease than those without skin disease. We found significant clustering of symptoms and signs: fever (P = 0.037), weight loss (P = 0.009), oral candidiasis (P = 0.038), pallor (P = 0.037) among HIV/AIDS subjects with skin diseases than those without. Low serum selenium concentration was significantly associated with primary skin disease of HIV/AIDS, such as pruritic papular eruption of AIDS (P = 0.003), xeroderma (P = 0.030), fluffy hair (P = 0.021), blue-black nail hyperpigmentation (P = 0.033) and secondary skin disease, such as oral candidiasis (P = 0.002). There was a significant association between low serum selenium concentration and increasing frequency of skin diseases (P = 0.002), but serum selenium was not significantly related to extents of distribution of skin diseases (P > 0.05). CONCLUSION: serum selenium concentration was lower among HIV subjects with skin diseases than those without skin disease. Pruritic papular eruption, xeroderma, fluffy hair, blue-black nail hyper pigmentation, and oral candidiasis were significantly associated with low serum selenium concentration.