CHARACTERISTICS OF DERMATOMYCOSIS AGAINST THE BACKGROUND OF HIV INFECTION

Abstract

Background. In the population of HIV-infected patients, superficial mycoses may have different clinical manifestations, evolution, and etiology, in contrast to those found in the population of people not infected with HIV. Aim: to describe superficial lesions of fungal etiology in HIV-infected patients and to compare them with a group of patients with onychomycosis of the feet who did not have HIV infection and concomitant diseases. Materials and methods. 63 patients with lesions of the skin and its appendages of fungal etiology were examined (30 HIV-positive patients and 33 individuals who made up the control group). We analyzed the location of the lesion, the time of development, and performed a mycological examination of skin samples with suspected fungal etiology of the lesion. Results. A statistically significant difference was found between HIV-infected patients and examined individuals of the control group in terms of the number of cases of Tinea unguium. The clinical picture of bedwetting was brighter in the group of HIV-positive patients. In HIV-infected patients, dermatophyte infection of the foot (Tinea pedis) and intertrigo of the feet (ringworm) are diagnosed significantly more often, compared to the group of patients with onychomycosis of the feet who did not have HIV infection and concomitant diseases (p<0.05-0.01 ). It is noteworthy that sedation always occurred under conditions of HIV load ≥50 copies/ml and the number of CD4+-lymphocytes <500 cells in 1 mm3 of blood serum. The clinical picture of onychomycosis in the compared groups also has differences. Thus, onycholysis and hyperkeratosis are statistically more common in HIV-infected persons (p<0.001). Onychodystrophy was characteristic only for patients with onychomycosis of the feet who did not have HIV infection and concomitant diseases (p<0.01). Distal-lateral subungual onychomycosis and white superficial onychomycosis were mainly caused by dermatomycetes, proximal subungual onychomycosis by yeast and mixed infection, and total dystrophic onychomycosis was usually caused by filamentous non-dermatomycetes. Conclusion. A relationship was established between the clinical forms of onychomycosis of the feet of HIV-infected patients and the types of the pathogen (χ2=6.483; df=2; p<0.05).