In this this study, 72.6% of HIV/AIDS pediatric patients attending care and treatment inTikurAnbesa Hospital had a wide range of mucocutaneous disorders. High prevalence of skin diseases among HIV infected children similar to this study has been reported in Tanzania (85%) , Thailand (83%)  and Cameroon (68.8%) . Other studies showed different results  the difference may be due to geographic variation and quality of care. A study by Luminus et al. showed that children less than five years of age are the least affected than the older ones, , but in our study there is no significant difference among younger and older children similar to that of Tanzanian study .
According to a study in Thailand the prevalence of mucocutanous disorder in sever, moderate and no evidence of immunosuppression was 62%, 43% and 20% respectively  and similar study in Tanzania showed 97%, 84.5% and 71% respectively. In this study, the prevalence of mucocutaneous disorders among children with severe, moderately severe and no evidence of immunosuppression was 100%, 70% and 48.3% respectively and the differences were statistically significant (p < 0.001). Most children with moderate and sever immunosuppression have two and more mucocutanous disorder . Similarly our study showed two and more skin disorders were more common in advanced immunosuppression.
All of the above studies including ours indicate that the risk of acquiring mucocutaneous disorders for HIV infected children rises as the level of immunosuppression advance. In this study Infectious dermatosis are the most frequent cause of mucocutaneous disorders among HIV infected children like other studies . In this study, the most common infectious dermatosis was superficial fungal infections and the most common non infectious dermatosis was prurritic popular eruption (PPE) similar to another study . The increased incidence of skin infections is attributed to the depletion of the Langerhan's cells responsible for the mucocutaneous immunological system.non infectious dermatosis also become prevalent whenthere is immunosuppression [5, 7].
Patients with HIV disease are particularly prone to hypersensitivity drug eruptions . In our study 6 children (3%) had moderate to severe drug rash secondary to nevirapine. kaposis sarcoma which is common cutaenous neoplasm in HIV infected adults is rare in children. In Tanzania study only one child was found to have kaposis sarcoma [5, 11]. In this study there was no a case of kaposis sarcoma indicating cutanous neoplasms are rare in children.
Study done by Sibhatu B et al. on adherence to HAART in pediatric patients in Addis Ababa at different hospitals including Tikur Anbesa (Black Lion) Hospital was 86% which is low compared to other setups . Some studies indicate that HAART decrease the prevalence of mucocutanous disorders especially viral infections in HIV infected individuals . But in our study and Tanzanian study , there was no significant difference in the prevalence of mucocutanous disorder among children on HAART and pre-ART care. For ART to have a significant effect on mucocutaneous disorders, it needs to be administered for a longer period of time and patients should be adherent to treatment. In a study by Donic I. et al., it was found that the use of ART for about two years reduced significantly the presence of oral candidosis and seborrheic dermatitis .
This study is cross sectional which does not allow us to assess treatment response and course of mucocutanous disorder and to see effect of HAART.