Chapter 25 - Skin Manifestations of HIV Infection

Abstract

It is noted that a skin disease can be the initial presentation of an underlying HIV infection and it may remain a major health problem during the patient's life. A prospective study confirmed that xerosis and seborrheic dermatitis are the most common skin findings. These manifestations as well as dermatophytic infections, common warts, and condylomata accuminata are also seen early, although the cases are usually not as severe as in more advanced HIV disease. The prevalences of acne vulgaris and eosinophilic folliculitis peak in mid-stage disease. On the other hand, chronic-ulcerative herpes-simplex infection, herpes zoster, oral candidiasis, molluscum contagiosum, and oral hairy leukoplakia are associated with late-stage disease when immunity is profoundly impaired. As patients become increasingly immunocompromised, these diseases tend to become more aggressive, appear more atypical, and respond less readily to treatment. However, widespread use of highly active antiretroviral therapy has not only effectively reduced morbidity and motality rates among HIV-infected persons, but also altered the development and course of many skin diseases.