Clinical Appearance Of Tinea Corporis Resembles With Tinea Imbricata And Condyloma Acuminata Genital In A Reproductive Woman With HIV : A Case Report

Indah Kencana(1*), Tutty Ariani(2), Qaira Anum(3), Yosse Rizal(4)

(1) Dermatology and Venereology Resident, Medical Faculty of Andalas University, Padang, West Sumatera, Indonesia
(2) Infection Division of Dermatology and Venereology Department, Medical Faculty of Andalas University, Padang, West Sumatera, Indonesia
(3) Sexually Transmitted Infection Division of Dermatology and Venereology Department, Medical Faculty of Andalas University, Padang, West Sumatera, Indonesia
(4) Infection Division of Dermatology and Venereology Department, Medical Faculty of Andalas University, Padang, West Sumatera, Indonesia
(*) Corresponding Author

DOI: https://doi.org/10.25077/aoj.5.2.285-300.2021

Abstract


Background: HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system that can cause immunodeficiency. Immunodeficiency results in increased susceptibility to fungal infections. The other opportunistic infection, condyloma acuminate is prevalent in groups at high risk for HIV acquisition and in HIV-infected individuals.

Case: There were ring-shaped reddish patches with scaly and itchy on the right back since 3 weeks ago. Patients often scratch it especially when sweating and hot weather. The itchy reddish patches with scaly were increased in number and size on the right back then spreading over the edge to form ring-like patches. Patient complained ring-shaped reddish patches getting more red, scaly, itchy, and wider. 6 months ago, there was a lump that sometime felt itchy in below part of vulva. Patient in reproductive age and not married yet, but sexually active. Patient had a sexual relation with male who HIV 2 years ago. Patient also suffered HIV and got ARV since 6 month ago. There was no protection (condom) during the sexual intercourse. Dermatologic state in right back with efflorescence is plaque erythema with annular concentric ring forms, scale, and blackish crust. Venereologycal state show vegetation in vulva with size 0,2 - 1,5 x 1 x 0,5 cm with verrucous surface. Acetowhite test is positive result. KOH 10% of skin scrapping show fungal element and fungal culture result is tricophyton rubrum. Patient was diagnosed tinea corporis (TC) and condyloma acuminata (CA) genital griseovulfin 900 mg, cetirizin 10 mg, ketokonazol 2% cream twice a day, tricholoroacetat 90% and showed good improvement.

Discussion: Diagnosis tinea corporis and CA genital based on clinical findings and mycological examination. Early diagnosis and proper treatment are important in HIV patients in order to prevent severe infection. After 4 weeks treatment, show improvement on TC however CA lesion no reduced.

Keywords: tinea corporis,condyloma acuminate, tinea imbricata, HIV, Reproductive age


Full Text:

PDF

References


Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. 2013.

Buchacz K, Lau B, Jing Y, et al. Incidence of AIDS-defining opportunistic infections in a multicohort analysis of hiv-infected persons in the United States and Canada, 2000–2010. J Infect Dis 2016; 214: 862–72.

Aly R, Berger T. Common superficial fungal infections in patients with AIDS. Clin Infect Dis 1996; 22 (Suppl. 2): S128–S132.

Elmets CA. Management of common superficial fungal infections in patients with AIDS. J Am Acad Dermatol 1994; 31: S60–S63.

Dahl MV. Dermatophytosis and the immune response. J Am Acad Dermatol 1994; 31: S34–S41.

Wagner DK, Sohnle PG. Cutaneous defenses against dermatophytes and yeasts. Clin Microbiol Rev 1995; 8: 317–355. 7 McGregor JM, Hay RJ. An immunoinhibitory cell wall glycoprotein (mannan) from Trichophyton rubrum. J Invest Dermatol 1991; 97: 955–956. 8 Hay RJ, Moore M. Mycology. In: Champion RH, Burton JL, Burns DA, Breathnach SM, eds. Textbook of Dermatology, 6th edn. London: Blackwell Science, 2001.

Chastain MA, Reed RJ, Pankey GA. Deep dermatophytosis: report of two cases and review of the literature. Cutis 2001; 67: 457–462. 10 Tsang P, Hopkins T, Jimenez-Lucho V. Deep dermatophytosis caused by Trichophyton rubrum in a patient with AIDS. J Am Acad Dermatol 1996; 34: 1090–1091.

Johnson RA. An update on dermatophytosis: dermatophyte infections in human immune deficiency virus (HIV) disease. J Am Acad Dermatol 2000; 43: S135–S142.

Lobrone JP, Lazare K, Medard FT, Zekeng L. Clinical and biological study of superficial mycoses in AIDS patients in Yaounde. Program and Abstracts of the 12th International Conference on AIDS, Geneva. Geneva: World Health Organization, 1998: Abstract 31218.

Banura C, Mirembe FM, Orem J, Mbonye AK, Kasasa S, Mbidde EK. Prevalence, incidence and risk factors for anogenital warts in Sub Saharan Africa: a systematic review and meta analysis. Infect Agent Cancer 2013; 8:27. [PMC free article] [PubMed] [Google Scholar]

Chin-Hong PV, Palefsky JM. Human papillomavirus anogenital disease in HIV-infected individuals. Dermatol Ther 2005; 18:67–76. [PubMed] [Google Scholar]

Houlihan CF, Larke NL, Watson-Jones D, et al. Human papillomavirus infection and increased risk of HIV acquisition. A systematic review and meta-analysis. AIDS 2012; 26:2211–22. [PMC free article] [PubMed] [Google Scholar]

Lissouba P, Van de Perre P, Auvert B. Association of genital human papillomavirus infection with HIV acquisition: a systematic review and meta-analysis. Sex Transm Infect 2013; 89:350–6. [PMC free article] [PubMed] [Google Scholar]

Smith JS, Moses S, Hudgens MG, et al. . Increased risk of HIV acquisition among Kenyan men with human papillomavirus infection. J Infect Dis 2010; 201:1677–85. [PMC free article] [PubMed] [Google Scholar]

Smith-McCune KK, Shiboski S, Chirenje MZ, et al. . Type-specific cervico-vaginal human papillomavirus infection increases risk of HIV acquisition independent of other sexually transmitted infections. PLoS One 2010; 5:e10094. [PMC free article] [PubMed] [Google Scholar]

Bennetts LE, Wagner M, Giuliano AR, Palefsky JM, Steben M, Weiss TW. Associations of Anogenital Low-Risk Human Papillomavirus Infection With Cancer and Acquisition of HIV. Sex Transm Dis 2015; 42:541–4. [PubMed] [Google Scholar]

19. Jin F, Prestage GP, Imrie J, et al. . Anal sexually transmitted infections and risk of HIV infection in homosexual men. J Acquir Immune Defic Syndr 2010; 53:144–9. [PubMed] [Google Scholar]

Averbach SH, Gravitt PE, Nowak RG, et al. . The association between cervical human papillomavirus infection and HIV acquisition among women in Zimbabwe. AIDS 2010; 24:1035–42. [PMC free article] [PubMed] [Google Scholar]

Tobian AA, Grabowski MK, Kigozi G, et al. . Human papillomavirus clearance among males is associated with HIV acquisition and increased dendritic cell density in the foreskin. J Infect Dis 2013; 207:1713–22. [PMC free article] [PubMed] [Google Scholar]


Refbacks

  • There are currently no refbacks.




Address for Correspondence:

Editorial Room Andalas Obstetrics and Gynecology Journal 3rd floor of KSM Obstetrics and Gynecology
RSUP Dr. M. Djamil Padang, Jl. Perintis Kemerdekaan Padang, Sumatara Barat, 25127