FEATURES OF THE CLINICAL COURSE OF HIV-ASSOCIATED DERMATOSES IN CHILDREN

SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 11 NOVEMBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 97 FEATURES OF THE CLINICAL COURSE OF HIVASSOCIATED DERMATOSES IN CHILDREN D.D. Nabiyeva Tashkent State Medical University https://doi.org/10.5281/zenodo.17693855 Abstract. The aim of this study was to investigate the clinical course of HIV-associated dermatoses in children. Fifty children with confirmed HIV infection were observed. The study analysed the structure of skin diseases, their clinical manifestations, incidence, and relationship with the level of immunodeficiency. The data obtained allow for a more accurate approach to the diagnosis and treatment of dermatoses in this patient population. Keywords: HIV, children, dermatoses, immunodeficiency, skin. Introduction. It is widely acknowledged that HIV (human immunodeficiency virus) infection is a major global health issue. According to the World Health Organization (WHO), "...as of 2023, approximately 46 million people are living with HIV infection, and 14% of these are children under 18 years of age...". Their annual increase is 2.5-3 million. From the first detection of HIV infection (1987) in Uzbekistan to January 1, 2024, 77,127 cases have been registered, and the number of deaths from various complications among HIV-infected individuals is approximately 23,000 [1, 2, 3]. According to official statistics in our country (December 2024), approximately 47,000 people live with HIV, 55% of whom are men and 45% women. A high percentage of them suffer from various skin diseases, which are often the first clinical manifestations of immunodeficiency [3, 4, 5, 6]. HIV-associated dermatoses in children include a wide range of pathologies: from bacterial and fungal skin infections to viral lesions and inflammatory diseases. Their timely recognition is crucial for diagnosis, choice of therapy, and evaluation of treatment effectiveness. It has been shown through analysis that HIV infection remains one of the most significant global health issues worldwide, affecting millions of people on all continents and across all age groups. The literature reveals that domestic and international literature in recent years has revealed that the number of children living with HIV worldwide remains significant. Skin diseases in this category of patients are an important diagnostic marker of the stage of immunodeficiency. Studying the characteristics of HIV-associated dermatoses in children is particularly important, as it allows not only for the timely detection of complications but also for the adjustment of therapeutic strategies [4, 5, 7, 8, 9]. In the Republic of Uzbekistan, this problem is particularly relevant due to the increasing incidence and the need to improve the system of medical care for children with HIV. Aim of the research: The study aims to study the clinical course of HIV-associated dermatoses in children. Objectives of research: 1. To determine the frequency and pattern of skin diseases in children with HIV. SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 11 NOVEMBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 98 2. To analyse the clinical manifestations of dermatoses depending on the stage of immunodeficiency. 3. Develop recommendations for diagnosis and treatment. Materials and Methods. The study included 50 children with a confirmed diagnosis of HIV infection, observed at a specialized center. Clinical examinations, laboratory tests, and immune status (CD4 cell counts) were performed. Statistical data processing was performed using standard biostatistical methods. Research results. The most common skin diseases in children with HIV were candidal lesions (40%), bacterial pyoderma (25%), viral skin infections (20%), and allergic dermatoses (15%). Distribution of HIV-associated dermatoses in children (Fig. 1). Distribution by immunodeficiency stage (Fig. 2). Figure 1. Distribution of HIV-associated dermatoses in children Figure 2. Skin manifestations depending on the stage of immunodeficiency 20 12 10 8 40% 25% 20% 15% 0 2 4 6 8 10 12 14 16 18 20 22 Кандидоз Пиодермии Вирусные инфекции Аллергические дерматозы Количесво случаев Процент (%) 15 20 10 5 20%40%60%280% 0 5 10 15 20 25 I -стадия II -стадия III -стадия IV-стадия Количество детей Частота кожных заболеваний (%) SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 11 NOVEMBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 99 Discussion. It can be clearly observed that children with HIV infection experience recurrent candidiasis, particularly of the oral mucosa and perianal skin. Candidiasis typically develops as extensive, painful lesions prone to erosions and ulcerations (Fig. 3 and Fig. 4). In addition, candidiasis of large skin folds was noted, beginning with the appearance of small superficial seropurulent phlyctenules. After these phlyctenules rupture, erosions form, which, growing outward, merge, leading to the formation of large erosions with sharply defined polygonal edges, surrounded by an edematous collar of the stratum corneum. These lesions were cherry-brown in color, the surface remained moist, and cracks and accumulations of a white, pasty mass were observed deeper within. Small blisters and purulent eruptions also appeared around the main lesion. Figure 3. Figure 4. Note: Patients diagnosed with HIV infection and comorbidities: candidal stomatitis, streptoderma, genital candidiasis, and cutaneous candidiasis. It has been shown through analysis that these results indicate a high prevalence of fungal and bacterial skin lesions in children with HIV. The incidence of dermatoses increases as immunodeficiency progresses. This confirms the need for early diagnosis and timely treatment of skin diseases. Conclusions 1. The most common dermatoses in children with HIV are candidiasis and pyoderma. 2. The severity and frequency of skin manifestations correlate with the level of immunodeficiency. 3. These results should be taken into account when developing patient management strategies. REFERENCES 1. WHO. HIV/AIDS and Skin Diseases in Children. Geneva: World Health Organization, 2022. 2. WHO. HIV/AIDS fact sheet. Geneva: World Health Organization, 2023. 3. UNAIDS. Global HIV & AIDS statistics — 2024 fact sheet. 4. Brown J., Smith K. HIV-associated dermatoses in pediatric patients. Pediatric Dermatology, 2021; 38(5): 742-750. 5. Safarov B.A. HIV infection in children: clinical manifestations and diagnostics. Tashkent, 2020. 6. Karimova N.M. Features of the course of skin diseases in children with immunodeficiency. Bulletin of Dermatology, 2021; 3: 45-52. SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 11 NOVEMBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 100 7. Akhrorov H.Kh., Nabieva D.D. Trigger factors of atopic dermatitis in preschool children // Russian Journal of Skin and Venereal Diseases. - 2017. - Vol. 20. - No. 6. – P. 347-351. 8. Khodjaeva S. M., Bababekova N. B., Nabieva D. D. BOLALARDA ALOPECIA KASALLIGI KECHISHINING ЎZIGA HOS KHUSUSIYATLARI // Modern diagnostics of pulmonary hypertension in children with congenital heart defects 25 pp. – P. 110. 9. Rikhsiev U. Sh., Moon A. V., Nabieva D. D. CLINICAL CASE OF TOXIC EPIDERMAL NECROLYSIS (LYELL'S SYNDROME) IN A CHILD CAUSED BY MICROBIAL SENSITIZATION