Selected topics in HIV-associated skin pathology

Abstract

The cutaneous manifestations of human immunodeficiency virus (HIV) infection have been the subject of intense scrutiny because the skin is the most commonly affected organ in HIV infected individuals. Infectious and non-infectious HIV-induced skin diseases may not only serve as the marker of HIV infection, but also as a marker of the stage of HIV disease. Although the cutaneous manifestations of opportunistic infections may serve as the sentinel lesion of a widely disseminated, life threatening infection, the majority of HIV-induced cutaneous diseases are not life threatening, but are cosmetically disfiguring and jeopardise the quality of life of HIV infected patients. The morphology of HIV-induced skin lesions is often unusual and clinically non-diagnostic. Histopathological appraisal is therefore pivotal in the accurate diagnosis of many HIV-induced skin diseases. Despite the changing trend of HIV-induced cutaneous manifestations following the use of highly active anti-retroviral therapy (HAART) in some countries, in developing countries where HAART is not readily and widely available, the skin continues to be ravaged by HIV infection. This review discusses selected HIV-related cutaneous infections and a range of dermatoses and neoplasms, and highlights the role of the histopathologist in the management of HIV infected patients.