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Karen Klickmann (847) 330-0101, ext. 341 [email protected]
HIV-RELATED SKIN DISEASES RESPOND WELL TO THERAPY
NEW YORK, NY (October 28, 1998) - From the beginning of the AIDS epidemic in 1981, the skin was observed to be a key barometer of immunodeficiency. Diseases such as seborrheic dermatitis (dandruff) and onychomycosis (nail fungus) appeared with modest drops in the immune system, or CD4 count. Similarly, Kaposi's sarcoma, oral candidiasis and herpes zoster appeared with the progressive loss of CD4 cells. With escalating levels of immunodeficiency, other serious skin diseases such as oral hairy leukoplakia, molluscum contagiosum, eosinophilic folliculitis and resistant herpes simplex are often seen, requiring treatment.
Speaking today at the American Academy of Dermatology's Derm Update '98, Marcus A. Conant, MD, Clinical Professor of Dermatology, University of California, San Francisco, CA, discussed the promising new results in the treatment of HIV-related skin diseases.
The association of herpes zoster, oral candidiasis, oral hairy leukoplakia and molluscum contagiosum with HIV was so significant that these cutaneous conditions were used as signs of disease progression in early clinical trials of antiviral medications. While these dermatological conditions are not as precise as the CD4 count in measuring the level of immunodeficiency, they are of great value in under-developed countries where expensive laboratory tests are not available. The good news is that with the introduction of combination antiretroviral therapy, patients' viral loads (the amount of HIV in the body) dropped to levels below the level of detection. In addition, the patients' disease did not progress or show signs of further complications. In many cases, general well being improved and CD4 counts began to rise. At the same time, patients with Kaposi's sarcoma showed almost immediate arrest in the rate of progression of their cancer, with progressive overall improvement in the disease when the viral load remained below the level of detection.
Eosinophilic folliculitis may initially flare with aggressive therapy, but it also clears as the CD4 count rises above 100. Molluscum contagiosum becomes easily manageable and candida and oral hairy leukoplakia clear.
"Thus, in the second phase of the AIDS epidemic, the treatment of choice for most HIV-associated skin diseases including Kaposi's sarcoma is aggressive antiretroviral therapy and maintenance of the viral load below the level of detection," Dr. Conant said.
The American Academy of Dermatology is the largest medical society representing physicians who specialize in treating skin, hair and nail conditions.
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REFERENCE NOTE: Conant, M.A., M.D.; et al.; Anonymous HIV Testing Using Home Collection and Telemedicine Counseling, Archives of Internal Medicine, 1997, Vol. 157, pp. 309-314.
Conant, M.A., M.D.; et al.; Reduction of Kaposi's Sarcoma Lesions following Treatment of AIDS with Ritonavir, Journal of AIDS, August 1997, pp. 1300-1301.
Conant, M.A., M.D.; Lessons from the AIDS Epidemic, Cutaneous Infection and Therapy, 1997, pp. 217-222.
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