The spectrum of HIV-associated infective and inflammatory dermatoses in pigmented skin.

HIV and AIDS patients often suffer from various skin infections of viral, bacterial, and fungal origin. In addition, parasitic infestations are prevalent. Common inflammatory dermatoses include seborrheic dermatitis, psoriasis, photodermatitis, and pruritic papular eruptions. This article discusses some of these conditions with an emphasis on clinical presentation. In patients with pigmented skin, diagnosis maybe challenging and complicated by dyspigmentation.

The impact of human immunodeficiency virus-related diseases on pigmented skin types.

Infection with human immunodeficiency virus (HIV) remains a significant problem globally. Early diagnosis and treatment with antiretroviral drugs has considerably improved health outcomes and decreased disease-related morbidity. HIV infection is associated with a wide range of skin disorders enabling dermatologists to diagnose HIV as well as associated opportunistic infections early in the course of disease. Despite concerted efforts by international health organizations to limit disease incidence, the prevalence of HIV infection remains high and is highest in sub-Saharan Africa. The diagnosis of HIV-related skin diseases is challenging as immunosuppression often results in atypical disease presentation. In addition, the clinical presentation will vary in pigmented skin types. The aim of this article is to describe disease variation in pigmented skin types.

A survey of skin disease and skin-related issues in Arab Americans.

BACKGROUND: There is a paucity of knowledge relating to dermatologic conditions in Arab Americans. OBJECTIVE: To assess common skin diseases and concerns and to evaluate access to dermatologic care and perception of skin in Arab Americans. METHODS: Arab Americans from 3 Southeast Michigan locations (community health center [n = 207], mosque [n = 95], and church [n = 99]) completed a survey questionnaire. RESULTS: The most common self-reported skin conditions were acne, eczema/dermatitis, warts, fungal skin infections, and melasma. The most pressing skin concerns were uneven skin tone, skin discoloration, dry skin, acne, and facial hair. Significant associations exist between socioeconomic status and having seen a dermatologist. Attitudes surrounding skin perception were related to the number of years of residence in the United States. LIMITATIONS: The skin condition data were gathered from a self-reported survey. CONCLUSIONS: Skin conditions and other related issues that affect Arab Americans are similar to those which affect other skin-of-color populations.

Scytalidium dimidiatum melanonychia and scaly plantar skin in four patients from the Maghreb: imported disease or outbreak in a Belgian mosque?

Scytalidium dimidiatum is a geophilic dematiaceous, non-dermatophyte mould that can become a pathogen for plants and humans particularly in tropical and subtropical regions. We report 4 cases of S. dimidiatum onychomycosis presenting clinically as thickened and dark toenails. The skin of the soles was scaly. The time and location of the contaminations were uncertain. Indeed, the patients were ancient immigrants from the Maghreb to Belgium. They were also regularly travelling to their countries of origin. They were also often barefoot in the same Belgian mosque. The disease was unresponsive to current oral antifungal treatments.

Ethnic and geographic differences and similarities of HIV/AIDS-related mucocutaneous diseases. Danida Study Groups.

BACKGROUND: A study on HIV/AIDS-related mucocutaneous manifestations has been carried out in three different ethnic and geographic areas, namely Brazil, Denmark, and Thailand. METHODS: The Brazil cohort comprised 110 patients, the Danish cohort 150, and the Thai cohort 206 patients. The majority of the Brazil and Thai cohort patients belonged to groups III and IV according to the CDC clinical staging system, whereas the patients in Denmark called their doctors earlier and only 8% were classified in groups III and IV. RESULTS: In all three areas the number of mucocutaneous diseases correlated well with the progression of the HIV disease. Ethnic differences were not identified, whereas geographic differences related to skin infections were marked. In the Asian cohort a generalized fungal infection was detected with characteristic mucocutaneous symptoms caused by Penicillium marneffei. CONCLUSIONS: Teaching efforts about mucocutaneous signs as markers of HIV infection may be of value, particularly in developing areas, to allow earlier diagnosis. In future guidelines for classification of HIV/AIDS-related mucocutaneous diseases geographic considerations should be included.

Lobomycosis in Colombian Amer Indian patients.

Several foci of lobomycosis among Colombian Amer Indians population were described in the Casanare region of Colombia, near the Orinoco river on the Colombian-Venezuelan border. This paper reports 16 new patients. The prevalence of Lobo's disease was 8.5% in the Amoruas tribe. Nodular lesions were located on the elbow, scapular and lumbar regions, knees, feet and legs. Leg lesions were especially numerous, were confluent and tended to ulcerate. All cases were confirmed histologically. Two Negro patients were also described. The cases bring the total number of confirmed patients with lobomycosis in Colombia to 41. Twenty-five of these were Amer Indian patients from tribes living in the Orinoco and Amazon basins of the country.

Tokelau: contribuicao ao estudo de uma dermatomicose do indigenas do Brasil / Tokelau: contribution to the one study dermatomycose of the aboriginals of Brazil

"Tokelau" e uma molestia tropical, em que grandes areas do corpo sao cobertas com aneis concentricos e anulares, pardacentos com grande numero de escamas. O rosto e o couro cabeludo, de um modo geral, sao isentos. A mesma, e proveniente de um fungo vegetal, encontrado na epiderme, particularmente na camada cornea. O micelio e abundante, os esporos mais raros. Ele e formado por longos e finos filamentos bifurcados, juntos uns aos outros. Os esporos sao arredondados, altamente refrataveis, variando no tamanho. Para observa-los e aos esporos, as escamas epidermicas, sao raspadas com um objeto cortante e postas em uma lamina microscopica, com uma gota de potassa caustica (10 a 40 por cento). Uma laminula e aplicada com certa pressao para aplanar as escamas. O fungo e estudado melhor com uma lente de imersao, entretanto pode ser visto com lentes comuns a seco. O "tokelau" foi observado pela primeira vez por William Dampier no Arquipelago Malaio. Manson, em 1876, descreveu as principais caracteristicas da dermatose, considerando-a uma micose epidermica, designando-a pelo nome "Tinea imbricata". Roquette Pinto observou a existencia de Mal no Brasil conforme e relatado em seu livro "Rondonia", Estado do Mato Grosso. Isso foi confirmado por Olimpio da Fonseca e outros. A cultura desse fungo foi obtida por muitos autores, como por exemplo Langeron, Sabouraud, Olimpio da Fonseca, etc. Admite-se em geral que o fungo isolado das escamas e o "Trichophyton concentricum", Blanchard 1896. Vicente Grieco observou no Mato Grosso, Alto Xingu, 11 casos de "tokelau", que sao descritos no artigo junto

Fungal infection as a cause of skin disease in the eastern province of Saudi Arabia: prevailing fungi and pattern of infection.

A total of 4,294 clinically suspected cases of dermatomycoses belonging to 26 different nationalities were examined between April 1984 and April 1988. Fungi were demonstrated in routine potassium hydroxide/dimethyl sulfoxide mount in 3,814 cases (88.8%) and the etiology was determined by culture in 2,458 cases (57.2%). Tinea versicolor was the predominant fungal infection (30.9% of all infections). Onychomycosis and paronychia ranked second in prevalence (16.8%). Candidal onychomycosis was the most common type of infection. Scalp ringworm among children ranked third (15.3%), Microsporum canis was the main etiologic agent. Tinea pedis and tinea manuum ranked fourth in prevalence (13.2%). Tinea corporis represented 10.7% of infections and M. canis was the main agent. Tinea cruris accounted for 8.7% of infections and Epidermophyton floccosum was the most common agent. Cutaneous candidosis constituted 4.3% of infections. White piedra was seen in 6 cases (0.16%). Yeasts were proved not to be unimportant as a cause of disease of skin and nail in our study.

Cutaneous infections in blacks.

We have described briefly a variety of cutaneous infections seen commonly but not exclusively in blacks. Some disorders are prevalent in blacks because of geography (high temperatures, humidity), environment, and low socioeconomic status causing over-crowding, malnutrition, and poor or delayed access to medical care. Only a few occur as a result of the unique way black hair or skin responds to trauma or infection. Physicians managing black patients with dermatologic problems should be aware of and must consider all the factors that initiate, aggravate, and perpetuate cutaneous responses under these conditions.