PYODERMA VEGETANS AS AN EARLY SIGN OF HIV-INFECTION

Skin and mucosal lesions are described in a 40-year-old man who suffered from HIV-infection in the stage of secondary diseases. The diagnosis was supported by demonstration of antibodies to HIV in the immune blotting test. The clinical manifestations were reduced to steady fever, generalized lymphadenopathy, pyoderma vegetans and chancriform pyoderma, candidiasis of the oral cavity, and seborrheic dermatitis. HIV-infection was diagnosed 4 years after the appearance of pyoderma which initially was amenable by external antibacterial agents and then became resistant to them. Eruptions of pyoderma vegetans simulating wide condylomas were located in inguinal folds, on the internal surface of the thighs and scrotum; the chancriform focus was located in the internal preputial layer. The treatment with azothymidine combined with antibacterial and antimycotic agents led to the improvement of the patient's general status and to the reduction of local lesions. However, on recommendations of an unknown witch-doctor who started treating him with the aid of reflexotherapy, phytotherapy and bioenergetic actions the patient stopped receiving the treatment prescribed and did not report for control examinations. After 5 months he died of brain edema.