PubMed · 2899756
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R J Hayes. 1988-08-06. Odds ratios and relative risks.. https://doi.org/10.1016/s0140-6736(88)92396-3
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Post-kala-azar dermal leishmaniasis (PKDL) is rarely reported in South America. In spite of the fact that there are many reports about the association of visceral leishmaniasis and AIDS, PKDL is very uncommon in HIV-positive patients, and so far only four cases have been documented in the literature. We present another case with unusual clinicopathological aspects. The patient, a 28-year-old male, from Salvador, Bahia (an endemic area) presented with clinical manifestations of visceral leishmaniasis three years after the diagnosis of AIDS. During treatment for visceral leishmaniasis he developed disseminated miliary papules. Microscopically, the skin biopsy showed a "saw-tooth" pattern with a lichenoid mononuclear infiltrate simulating lichen planus. The histopathological diagnosis was achieved through the finding of amastigotes. The authors discuss the clinicopathological aspects of this case based on a review of the specific literature.
We prospectively assessed serum lactate and plasma HIV viral load in 20 patients with stavudine-related nucleoside neuropathy, 10 with HIV-related distal sensory polyneuropathy (DSPN), 20 receiving stavudine but without neuropathy and 23 not receiving stavudine and without neuropathy. Raised serum lactate levels discriminated between stavudine nucleoside neuropathy and DSPN with 90% sensitivity and 90% specificity (P = 0.001). DSPN occurred despite an undetectable viral load, making it a poor discriminator.