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fungal infections and insect bite reactions. Dermatoses in the TABLE 1: Demographic and clinical characteristics of human immunodeficiency
non-infectious group were separated into inflammatory, virus-positive patients with skin disease (N = 100). %
n
Variable
neoplastic, drug-related and other conditions. These Gender
characteristics were grouped based on clinically significant Male 41 41.0
cut-off points and published data. 14,15,16,17,18,19,20 Female 59 59.0
Ethnicity
Data analysis Black 75 75.0
Mixed ancestry 17 17.0
Continuous variables were summarised as mean and White 8 8.0
standard deviation (s.d.), whilst nominal variables were CD4+ cell count (cells/µL)
summarised as counts and percentages. Pearson’s chi-square < 200 31 31.0
test was used to assess the possible association between skin ≥ 200 69 69.0
disease category and patient demographics (gender and Viral load (copies/mL)
ethnicity) or HIV disease characteristics (CD4+ cell count, Undetectable 52 52.0
viral load and duration of ART). Data were analysed using Detectable 48 48.0
ART regimen
STATA (version 15; Stata Corp., College Station, Texas, USA) Not taking ART 26 26.0
and statistical significance was set at p < 0.05. Taking ART 74 74.0
Duration of ART treatment†
Ethical consideration ≤ 1 year 29 39.2
> 1 year 45 60.8
Ethical approval was obtained from the Health Research †, Percentages calculated relative to n = 74 patients who were taking ART at the time of the
Ethics Committee of Stellenbosch University (N16/05/071). study.
The study was also approved by the management of Karl ART, antiretroviral therapy; NNRTI, non-nucleoside reverse transcriptase inhibitor; PI, protease
inhibitor.
Bremer Hospital. Participation was voluntary and all
participants provided written informed consent to take part TABLE 2: Spectrum of dermatoses recorded for human immunodeficiency virus-
in the study. All data were anonymised to ensure the privacy positive patients (N = 100). n %
Dermatoses
and confidentiality of participants’ personal information and Infectious dermatoses 50 50.0
each participant was assigned a unique identifier. Bacterial 8 8.0
Viral 14 14.0
Results Fungal 28 28.0
Non-infectious dermatoses 71 71.0
We observed mucocutaneous disease in 123 patients out of a Inflammatory 50 50.0
total of 970 who were screened, which is equivalent to a Neoplastic 5 5.0
prevalence of 12.7% (95% CI 0.11–0.15). The demographic and Drug related 2 2.0
clinical characteristics of the sample (N = 100 patients who Other 14 14.0
provided informed consent) are summarised in Table 1. The
mean age (± s.d.) was 40.4 (± 10.1) years. There were slightly infections (n = 8, 8.0%). Fungal infections included oral
more women (59%) than men (41%). Most participants were candidiasis (n = 6), pityriasis versicolor (n = 4), intertriginous
black people (75%), had a CD4+ cell count ≥ 200 cells/µL candidiasis (n = 1) and a spectrum of dermatophytosis
(69%) and were on ART (74%). Of those participants on ART (n = 17), namely, tinea corporis (n = 8), onychomycosis (n = 5)
(n = 74), most (n = 65; 87.8%) were on an NNRTI-based (Figure 1), tinea pedis (n = 3) and tinea faciei (n = 1). Overall,
regimen, whilst nine (12.2%) participants were on a PI-based tinea corporis (8.0%) and oral candidiasis (6.0%) were the
regimen. Most patients (n = 45; 60.8%) had been on ART for most prevalent of all infectious conditions. Bacterial infections
more than a year. One-third of the sample (35%) had a normal included ecthyma (n = 3), folliculitis (n = 2), cellulitis (n = 1),
weight (BMI 18.5–24), 24% were overweight (BMI 25–30) and impetigo (n = 1) and secondary syphilis (n = 1), whilst viral
14% were obese (BMI > 30). Very few patients (7%) were infections included condylomata acuminata (n = 4), herpes
classified as being underweight (BMI < 18.5). We were unable zoster (n = 2), molluscum contagiosum (n = 2), orolabial
to calculate the BMI for 20 patients because of missing weight herpes simplex (n = 2), anogenital herpes simplex (n = 1),
or height statistics in patient folders. generalised verrucosis (n = 1), oral hairy leukoplakia (n = 1)
and viral exanthem (n = 1).
A total of 121 dermatoses were identified in 100 study
participants. The number of participants who presented with Non-infectious dermatoses affected 71.0% of the sample.
dual and triple pathology was 20 and 1, respectively. The Of the non-infectious dermatoses, inflammatory
spectrum of dermatoses in this sample is summarised in dermatoses were the most common (n = 50) and included
Table 2. pruritic papular eruption (PPE) (n = 20) (Figure 2),
seborrheic dermatitis (n = 6), angular cheilitis (n = 4), atopic
Infectious dermatoses affected half of the participants in the dermatitis (n = 4), contact dermatitis (n = 4), insect bite
sample. Fungal infections were the most prevalent (n = 28, reaction (grouped urticarial papules on exposed sites such
28.0%), followed by viral (n = 14, 14.0%) and bacterial as the head, neck and distal extremities) (n = 4), dermatitis

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