Hyper IgE, Dermatitis and Staphylococcus aureus in an HIV-Positive Man

Abstract

A variety of mucocutaneous disorders are seen in patients infected with Human immunodeficiency virus (HIV) [1]. While some of these conditions like Kaposi’s sarcoma are considered acquired immunodeficiency syndrome (AIDS)-defining illnesses, most HIV patients suffer from common infectious and inflammatory skin disorders like folliculitis and psoriasis [2]. Psoriasis in HIV patients presents more severely and is associated with a worse outcome [3]. The skin cytokine expression in HIV patients is altered [4] and elevated levels of IgE, a hallmark of atopic disorders, were observed in HIVinfected adults and children [5-7]. Studies have shown that HIV glycoproteins can act as viral superantigens and contribute to the release of IgE and histamine, leading to a shift of the T cell response towards the Th2 phenotype [8]. The skewing towards Th2 cytokines is thought to predispose HIV-infected patients to atopic dermatitis and account for the increased incidence of atopic dermatitis observed in HIV patients [2].