Document 0170
 DOCN  M9460170
 TI    Photosensitivity as the presenting illness in four patients with human
       immunodeficiency viral infection.
 DT    9408
 AU    Pappert A; Grossman M; DeLeo V; Environmental Dermatology Unit,
       Columbia-Presbyterian Medical; Center, New York, NY.
 SO    Arch Dermatol. 1994 May;130(5):618-23. Unique Identifier : AIDSLINE
       MED/94234741
 AB    BACKGROUND: A multitude of skin lesions have been reported in
       individuals with human immunodeficiency virus (HIV) infection. Some of
       them, eg, severe seborrheic dermatitis and herpes zoster infections, may
       predate the onset of the diagnostic criteria for the acquired
       immunodeficiency syndrome and may actually raise the suspicion of HIV
       infection in healthy-appearing individuals. We have recently evaluated
       four individuals who presented with a severe idiopathic photosensitivity
       of eczematous morphologic features who eventuated in a diagnosis of HIV
       seropositivity. Four individuals who presented with an eczematous
       eruption of sun-exposed skin were referred to the Environmental
       Dermatology Unit of Columbia-Presbyterian Medical Center (New York, NY)
       for evaluation of possible photosensitive disease. They were examined
       and underwent photobiological testing (minimal erythema dose testing and
       photopatch testing) to confirm and classify their suspected
       photosensitivity. OBSERVATIONS: All four patients fulfilled the criteria
       for chronic actinic dermatitis, a rare idiopathic photosensitivity
       characterized by debilitating, unremitting dermatitis with eczematous or
       lymphomalike histologic features and reproduction of lesions by small
       quantities of mid-wave UV-B radiation (290 to 320 nm). All four
       individuals were HIV seropositive and CD4 counts were markedly
       suppressed in all four. The photosensitivity predated the finding of
       seropositivity and the diagnosis of acquired immunodeficiency syndrome
       in all four patients. CONCLUSION: The presentation of healthy-appearing
       individuals with photodistributed dermatitis of unknown cause should
       alert the physician to the possibility of HIV infection.
 DE    Adult  Case Report  Human  HIV Infections/*COMPLICATIONS  Male  Middle
       Age  Photosensitivity Disorders/*COMPLICATIONS/DIAGNOSIS  JOURNAL
       ARTICLE

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