Biomedical subjects
Publications and source records attributed to L E Gately.
Infection with HIV can result in many cutaneous disorders, some of which may be the presenting sign of the disease. The cutaneous manifestations may be infectious or noninfectious. This article reviews the numerous cutaneous infectious findings, neoplasms, and dermatoses seen in HIV-infected individuals.
One of the earliest methods for investigating the immunologic basis of disease was the use of immunofluorescence (IF) on skin biopsy specimens and serum. IF can be used to detect immunoglobulins, complement components, and fibrin. In some diseases, the IF findings are disease specific and diagnostic, especially in certain bullous diseases. The use of IF testing has increased with the recent development of the salt split skin technique. The newer IF findings in some well-established immunodermatologic diseases and several recently described diseases are discussed. A brief description of the techniques involved in direct and indirect IF is also presented.
Of two patients with discoid lupus erythematosus with eyelid involvement, one, a 42-year-old man, had a one-year history of persistent periorbital edema and a violaceous discoloration as the sole manifestation. Although treatment with corticosteroids and antihistamines failed to produce improvement, the patient had an excellent clinical response to systemic hydroxychloroquine therapy. Histologic examination with immunofluorescent staining demonstrated deposition of immunoglobulins at the dermoepidermal junction. The second patient, a 37-year-old woman, had a hyperpigmented lesion on her forearm as the initial symptom but later developed similar lesions elsewhere, including her lower eyelid. Treatment with hydroxychloroquine again produced an excellent response.
Two hundred fifty-one black patients were examined for the presence of melanocytic nevi. The average number detected was 8.3 per patient. Light-skinned blacks had a greater number of total body nevi, while dark-skinned blacks had more lesions on the palms and soles. The usual histologic pattern seen in plantar-palmar lesions was that of lentigo simplex. The differentiation of lentigines of the palms and soles from early expression of acral lentiginous melanomas may be difficult; however, most acral pigmented lesions do not require excision.
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