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February 1991

Generalized Chronic Dermatophytosis in Patients With Human Immunodeficiency Virus Type I Infection and CD4 Depletion

Author Affiliations

USA; USA; USA; USA; Walter Reed Retrovirus Research Group Dermatology Service Department of Medicine Walter Reed Army Medical Center Washington, DC 20307-5001

Arch Dermatol. 1991;127(2):265-266. doi:10.1001/archderm.1991.01680020137024

To the Editor.—  Cutaneous and mucocutaneous disorders were some of the earliest recognized complications occurring in persons infected with the human immunodeficiency virus 1 (HIV-1). Oral and vaginal candidiasis, tinea pedis, onychomycosis, and deep mycotic infections have been the fungal infections most frequently reported in these patients.1 These infections occur predominantly in those patients with severe immunologic dysfunction characterized by CD4 lymphocyte depletion and/or anergy. We describe three CD4-deficient, HIV-1-infected patients in whom generalized chronic dermatophytosis developed.

Report of Cases.—Case 1.—  A 29-year-old man with transfusionacquired HIV-1 infection and central nervous system toxoplasmosis presented with a 2-month history of a pruritic eruption that had appeared initially in his groin and progressively spread downward over both legs and upward onto his abdomen over the next 3 months. On physical examination a raised, erythematous, confluent, scaly eruption extended from his umbilicus to his ankles and involved approximately 30%

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