RESUMO
OBJECTIVE: To document the prevalence of dermatologic manifestations in patients infected with the human immunodeficiency virus (HIV) on presentation to primary medical care. DESIGN: Prospective consecutive case series evaluated between June and November 1995. SETTING: The HIV intake clinic at an urban hospital. SUBJECTS AND METHODS: Ninety-five individuals initiating HIV-related primary care. RESULTS: Dermatologic manifestations were found in 82 patients (86%). The most common conditions were dermatophytosis in 32 patients (34%), oral hairy leukoplakia in 22 (23%), and folliculitis in 18 (19%). Well-described HIV-associated dermatologic manifestations such as Kaposi sarcoma, herpes zoster, and psoriasis were uncommon. CONCLUSIONS: The high prevalence of treatable skin disorders found in HIV-infected patients underscores the importance of careful and complete skin examination as a fundamental aspect of the initial clinical evaluation in this population.
Assuntos
Infecções por HIV/complicações , Dermatopatias/virologia , Adulto , Boston , Dermatomicoses/virologia , Feminino , Foliculite/virologia , Infecções por HIV/etiologia , Humanos , Leucoplasia Pilosa/virologia , Masculino , Atenção Primária à Saúde , Estudos Prospectivos , Fatores de RiscoAssuntos
Antipsicóticos/efeitos adversos , Antipsicóticos/uso terapêutico , Hiperprolactinemia/induzido quimicamente , Hiperprolactinemia/tratamento farmacológico , Pirenzepina/análogos & derivados , Adulto , Amenorreia/induzido quimicamente , Amenorreia/tratamento farmacológico , Benzodiazepinas , Feminino , Galactorreia/induzido quimicamente , Galactorreia/tratamento farmacológico , Humanos , Pessoa de Meia-Idade , Olanzapina , Perfenazina/efeitos adversos , Perfenazina/uso terapêutico , Pirenzepina/uso terapêutico , Risperidona/efeitos adversos , Risperidona/uso terapêutico , Esquizofrenia/tratamento farmacológicoRESUMO
BACKGROUND: Surgical resection has been the usual therapy for HIV-infected patients with lymphoepithelial parotid cysts. OBJECTIVE: To study antiretroviral therapy for lymphoepithelial parotid cysts. DESIGN: Case series. SETTING: HIV outpatient clinics. PATIENTS: HIV-infected patients with lymphoepithelial parotid cysts. INTERVENTION: Antiretroviral therapy. MEASUREMENTS: Change in size of the parotid cyst, CD4 lymphocyte count, and HIV viral load. RESULTS: Nine HIV-infected adults presented with chronic, large parotid cysts, eight of which were bilateral. In at least seven patients, the cysts were the initial sign of HIV infection. In six patients, the cysts resolved completely with combination antiretroviral therapy. Four of these patients also received prednisone. Three patients who did not comply with antiretroviral therapy had partial responses followed by relapses. CONCLUSIONS: Parotid cysts are an unrecognized sign of early HIV infection. These cysts respond to combination antiretroviral therapy, with or without corticosteroids. Surgical resection should be reserved for patients in whom medical therapy has failed or those who refuse or are poorly compliant with medical therapy.