Cutaneous manifestations of human immunodeficiency virus in Lusaka, Zambia.

Of the 1124 human immunodeficiency virus (HIV)-infected patients studied, one or more cutaneous lesions were found in 113 (98.3%) of the 115 patients with acquired immunodeficiency syndrome (AIDS) and in 541 (53.6%) of 1009 patients with AIDS-related complex (ARC). Kaposi's sarcoma, multidermatomal, necrotic herpes zoster, and pruritic maculopapular rashes are common cutaneous manifestations of AIDS and its related complex (ARC) in Zambia. The maculopapular rash results from a lymphoplasmacytic angiitis in the dermis, possibly in response to the presence of HIV in the dermis. Candidiasis, severe genital herpes, extensive molluscum contagiosum, and tinea corporis were less frequent and usually refractory to treatment. Drug reactions are also frequent in Zambians with AIDS. In seven patients given streptomycin, thiacetazone, and rifampicin for treatment of pulmonary tuberculosis, Stevens-Johnson syndrome occurred shortly after therapy was begun, and two died despite high-dose prednisone and discontinuance of tuberculosis therapy. Extensive seborrheic dermatitis refractory to topical fluorinated corticosteroids is also an associated condition in AIDS patients who have pulmonary tuberculosis.