Dermatologic manifestations of underlying infectious disease among illicit injection-drug users

Drug use patterns and serious bloodborne infections commonly have dermatologic manifestations among illicit injection-drug users (IDUs).

To assess how self-reported skin conditions of IDUs may correlate with underlying infectious diseases after adjustment for drug use patterns.

Prospective analysis of factors associated with self-reports of skin rashes, cellulitis, oral lesions, and lymphadenopathy obtained from 1,065 IDUs enrolled in a large cohort study. Variables potentially associated with each outcome were evaluated using multivariate generalized estimating equations.

In multivariate analyses, drug use patterns were associated with cellulitis, whereas human immunodeficiency virus (HIV) infection and hepatitis C (HCV) were not. HCV infection was independently associated with skin rashes (odds ratio [OR] 1.85; 95% CI 1.17-2.94). HIV infection was independently associated with lymphadenopathy (OR 2.00; 95% CI 1.52-2.63), skin rash (OR 2.12; 95% CI 1.57-2.86), and oral lesions (OR 14.95; 95% CI 9.41-23.76).

Self-reports of IDUs, which could easily be obtained as part of a functional inquiry in a clinical setting, correlate with specific drug use patterns and underlying bloodborne infections.