In the early phases of the HIV epidemic, skin disease was frequently a presenting manifestation of the infection.[1] Cutaneous manifestations often reflect immune status and may offer insight into long-term prognosis. Although morbidity from skin diseases, particularly from opportunistic infections, has decreased with the advent of antiretroviral treatment, significant dermatologic problems may still occur. Dermatologic disorders in HIV may be categorized as infectious, inflammatory, neoplastic, drug reaction, and metabolic.
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HIV-associated lipodystrophy revealing facial atrophy
Eosinophilic folliculitis on cheek
Eosinophilic folliculitis on chest
Oral hairy leukoplakia
Oral hairy leukoplakia
Oral hairy leukoplakia
Papular pruritic eruption on forearm
Photodermatitis on sun-exposed area - arm
Photodermatitis on sun-exposed area - dorsum of hand
Photodermatitis on sun-exposed area - lower face
Prurigo nodularis showing nodules and hyperpigmentation on forearm
Kaposi sarcoma on lower extremities
Kaposi sarcoma on palate
Psoriatic plaques showing well-marginated silvery scale on erythematous base
Inverse psoriasis on soles of feet
Inverse psoriasis on palms of hands
Seborrheic dermatitis showing typical distribution on face
Atopic dermatitis on antecubital fossa
Xerosis
Perioral dermatitis
Acne vulgaris on face
Molluscum contagiosum on cheek
Human papillomavirus on soles of feet
Herpes simplex virus on buttocks
Herpes simplex virus mimicking staphylococcal infection
Varicella zoster virus on the back
Staphylococcal ulcers
Staphylococcal folliculitis
Botryomycoses in axilla
Bacillary angiomatosis
Syphilis on sole of foot
Syphilis eruption on chest
Scabetic burrows
Crusted scabies
Basal cell carcinoma
Melanoma
Squamous cell carcinoma
Toxic epidermal necrolysis
Citations
World Health Organization. Guidelines on the treatment of skin and oral HIV-associated conditions in children and adults. 2014 [internet publication].[Full Text]
Maurer TA. Dermatologic manifestations of HIV infection. Top HIV Med. 2005;13(5):149-54.[Abstract]
1. Leslie KS, Levell NJ. Dermatologists, beacons of epidemics; past, present and future! Int J Dermatol. 2004 Jun;43(6):468-70.[Abstract]
2. World Health Organization. Guidelines on the treatment of skin and oral HIV-associated conditions in children and adults. 2014 [internet publication].[Full Text]
3. Paul S, Evans R, Maurer T, et al. Treatment of dermatological conditions associated with HIV/AIDS: the scarcity of guidance on a global scale. AIDS Res Treat. 2016 May 3;2016:3272483.[Abstract][Full Text]
4. Mallon PW, Unemori P, Sedwell R, et al. In vivo, nucleoside reverse-transcriptase inhibitors alter expression of both mitochondrial and lipid metabolism genes in the absence of depletion of mitochondrial DNA. J Infect Dis. 2005 May 15;191(10):1686-96.[Abstract][Full Text]
5. Bastard JP, Caron M, Vidal H, et al. Association between altered expression of adipogenic factor SREBP1 in lipoatrophic adipose tissue from HIV-1-infected patients and abnormal adipocyte differentiation and insulin resistance. Lancet. 2002 Mar 23;359(9311):1026-31.[Abstract]
6. Rosenthal D, LeBoit PE, Klumpp L, et al. Human immunodeficiency virus-associated eosinophilic folliculitis. A unique dermatosis associated with advanced human immunodeficiency virus infection. Arch Dermatol. 1991 Feb;127(2):206-9.[Abstract]
7. Holmes RB, Martins C, Horn T. The histopathology of folliculitis in HIV-infected patients. J Cutan Pathol. 2002 Feb;29(2):93-5.[Abstract]
8. Resneck JS Jr., Van Beek M, Furmanski L, et al. Etiology of pruritic papular eruption with HIV infection in Uganda. JAMA. 2004 Dec 1;292(21):2614-21.[Abstract][Full Text]
9. Huang AH, Canner JK, Khanna R, et al. Real-world prevalence of prurigo nodularis and burden of associated diseases. J Invest Dermatol. 2020 Feb;140(2):480-3;e4.[Abstract][Full Text]
10. Boozalis E, Tang O, Patel S, et al. Ethnic differences and comorbidities of 909 prurigo nodularis patients. J Am Acad Dermatol. 2018 Oct;79(4):714-9;e3.[Abstract][Full Text]
11. Hernández-Ramírez RU, Shiels MS, Dubrow R, et al. Cancer risk in HIV-infected people in the USA from 1996 to 2012: a population-based, registry-linkage study. Lancet HIV. 2017 Nov;4(11):e495-504.[Abstract][Full Text]
12. Crum-Cianflone N, Hullsiek KH, Satter E, et al. Cutaneous malignancies among HIV-infected persons. Arch Intern Med. 2009 Jun 22;169(12):1130-8.[Abstract][Full Text]
13. Müller M, Wandel S, Colebunders R, et al; IeDEA Southern and Central Africa. Immune reconstitution inflammatory syndrome in patients starting antiretroviral therapy for HIV infection: a systematic review and meta-analysis. Lancet Infect Dis. 2010 Apr;10(4):251-61.[Abstract]
14. Miziara ID, Araujo Filho BC, Weber R. AIDS and recurrent aphthous stomatitis. Rev Bras Otorhinolaryngol. 2005 Jul-Aug;71(4):517-20.[Abstract][Full Text]
15. Duvic M, Johnson TM, Rapini RP, et al. Acquired immunodeficiency syndrome-associated psoriasis and Reiter's syndrome. Arch Dermatol. 1987 Dec;123(12):1622-32.[Abstract]
16. Menon K, Van Voorhees AS, Bebo BF Jr, et al; National Psoriasis Foundation. Psoriasis in patients with HIV infection: from the medical board of the National Psoriasis Foundation. J Am Acad Dermatol. 2010 Feb;62(2):291-9.[Abstract]
17. Maurer T, Rodrigues LK, Ameli N, et al. The effect of highly active antiretroviral therapy on dermatologic disease in a longitudinal study of HIV type 1-infected women. Clin Infect Dis. 2004 Feb 15;38(4):579-84.[Abstract][Full Text]
18. Dunic I, Vesic S, Jevtovic DJ. Oral candidiasis and seborrheic dermatitis in HIV-infected patients on highly active antiretroviral therapy. HIV Med. 2004 Jan;5(1):50-4.[Abstract][Full Text]
19. Siberry GK, Leister E, Jacobson DL, et al. Increased risk of asthma and atopic dermatitis in perinatally HIV-infected children and adolescents. Clin Immunol. 2012 Feb;142(2):201-8.[Abstract][Full Text]
20. Kaushik SB, Cerci FB, Miracle J, et al. Chronic pruritus in HIV-positive patients in the southeastern United States: its prevalence and effect on quality of life. J Am Acad Dermatol. 2014 Apr;70(4):659-64.[Abstract]
21. Lee D, Benson CA, Lewis CE, et al. Prevalence and factors associated with dry skin in HIV infection: the FRAM study. AIDS. 2007 Oct 1;21(15):2051-7.[Abstract][Full Text]
22. Scott C, Staughton RC, Bunker CJ, et al. Acne vulgaris and acne rosacea as part of immune reconstitution disease in HIV-1 infected patients starting antiretroviral therapy. Int J STD AIDS. 2008 Jul;19(7):493-5.[Abstract]
23. Winchester R, Bernstein DH, Fischer HD, et al. The co-occurrence of Reiter's syndrome and acquired immunodeficiency. Ann Intern Med. 1987 Jan;106(1):19-26.[Abstract]
24. Fernando I, K Edwards S, Grover D. British Association for Sexual Health and HIV national guideline for the management of genital molluscum in adults (2021). Int J STD AIDS. 2022 Apr;33(5):422-32.[Abstract][Full Text]
25. Wood SM, Shah SS, Steenhoff AP, et al. Primary varicella and herpes zoster among HIV-infected children from 1989 to 2006. Pediatrics. 2008 Jan;121(1):e150-6.[Abstract]
26. Frean J, Arndt S, Spencer D. High rate of Bartonella henselae infection in HIV-positive outpatients in Johannesburg, South Africa. Trans R Soc Trop Med Hyg. 2002 Sep-Oct;96(5):549-50.[Abstract]
27. Lanjewar DN, Bhosale A, Iyer A. Spectrum of dermatopathologic lesions associated with HIV/AIDS in India. Indian J Pathol Microbiol. 2002 Jul;45(3):293-8.[Abstract]
28. Minga KA, Gberi I, Boka MB. Bacillary angiomatosis in an adult infected with HIV-1 at an early stage of immunodepression in Abidjan, Cote d'Ivoire [in French]. Bull Soc Pathol Exot. 2002 Mar;95(1):34-6.[Abstract]
29. Ciervo A, Petrucca A, Ciarrocchi S, et al. Molecular characterization of first human Bartonella strain isolated in Italy. J Clin Microbiol. 2001 Dec;39(12):4554-7.[Abstract][Full Text]
30. Gazineo JL, Trope BM, Maceira JP, et al. Bacillary angiomatosis: description of 13 cases reported in five reference centers for AIDS treatment in Rio de Janeiro, Brazil. Rev Inst Med Trop Sao Paulo. 2001 Jan-Feb;43(1):1-6.[Abstract][Full Text]
31. Gutierrez-Galhardo MC, do Valle GF, Sa FC, et al. Clinical characteristics and evolution of syphilis in 24 HIV+ individuals in Rio de Janeiro, Brazil. Rev Inst Med Trop Sao Paulo. 2005 May-Jun;47(3):153-7.[Abstract][Full Text]
32. Gare J, Lupiwa T, Suarkia DL, et al. High prevalence of sexually transmitted infections among female sex workers in the eastern highlands province of Papua New Guinea: correlates and recommendations. Sex Transm Dis. 2005 Aug;32(8):466-73.[Abstract]
33. Hesketh T, Tang F, Wang ZB, et al. HIV and syphilis in young Chinese adults: implications for spread. Int J STD AIDS. 2005 Mar;16(3):262-6.[Abstract]
34. Nnoruka EN, Ezeoke AC. Evaluation of syphilis in patients with HIV infection in Nigeria. Trop Med Int Health. 2005 Jan;10(1):58-64.[Abstract][Full Text]
35. Ryder N, Bourne C, Rohrsheim R. Clinical audit: adherence to sexually transmitted infection screening guidelines for men who have sex with men. Int J STD AIDS. 2005 Jun;16(6):446-9.[Abstract]
36. Dougan S, Elford J, Rice B, et al. Epidemiology of HIV among black and minority ethnic men who have sex with men in England and Wales. Sex Transm Infect. 2005 Aug;81(4):345-50.[Abstract][Full Text]
37. Wong W, Chaw JK, Kent CK, et al. Risk factors for early syphilis among gay and bisexual men seen in an STD clinic: San Francisco, 2002-2003. Sex Transm Dis. 2005 Jul;32(7):458-63.[Abstract]
38. Fenton KA, Imrie J. Increasing rates of sexually transmitted diseases in homosexual men in Western Europe and the United States: why? Infect Dis Clin North Am. 2005 Jun;19(2):311-31.[Abstract]
39. del Amo J, Gonzalez C, Losana J, et al. Influence of age and geographical origin in the prevalence of high risk human papillomavirus in migrant female sex workers in Spain. Sex Transm Infect. 2005 Feb;81(1):79-84.[Abstract][Full Text]
40. Soni S, Horner P, Rayment M, et al. British Association for Sexual Health and HIV national guideline for the management of infection with Mycoplasma genitalium (2018). Int J STD AIDS. 2019 Sep;30(10):938-50.[Abstract][Full Text]
41. Rönn MM, Ward H. The association between lymphogranuloma venereum and HIV among men who have sex with men: systematic review and meta-analysis. BMC Infect Dis. 2011 Mar 18;11:70.[Abstract][Full Text]
42. Lautenschlager S, Kemp M, Christensen JJ, et al. 2017 European guideline for the management of chancroid. Int J STD AIDS. 2017 Mar;28(4):324-29.[Abstract]
43. Bosch RJ, Rodrigo AB, Sanchez P, et al. Presence of Leishmania organisms in specific and non-specific skin lesions in HIV-infected individuals with visceral leishmaniasis. Int J Dermatol. 2002 Oct;41(10):670-5.[Abstract]
44. Choi CM, Lerner EA. Leishmaniasis: recognition and management with a focus on the immunocompromised patient. Am J Clin Dermatol. 2002;3(2):91-105.[Abstract]
45. Bittencourt A, Silva N, Straatmann A, et al. Post-kala-azar dermal leishmaniasis associated with AIDS. Braz J Infect Dis. 2002 Dec;6(6):313-6.[Abstract][Full Text]
46. Agostoni C, Dorigoni N, Malfitano A, et al. Mediterranean leishmaniasis in HIV-infected patients: epidemiological, clinical, and diagnostic features of 22 cases. Infection. 1998 Mar-Apr;26(2):93-9.[Abstract]
47. Barrio J, Lecona M, Cosin J, et al. Leishmania infection occurring in herpes zoster lesions in an HIV-positive patient. Br J Dermatol. 1996 Jan;134(1):164-6.[Abstract]
48. Jimenez-Gonzalez C, Mata-Marin JA, Arroyo-Anduiza CI, et al. Prevalence and etiology of onychomycosis in the HIV-infected Mexican population. Eur J Dermatol. 2013 May-Jun;23(3):378-81.[Abstract]
49. Omland SH, Ahlström MG, Gerstoft J, et al. Risk of skin cancer in patients with HIV: a Danish nationwide cohort study. J Am Acad Dermatol. 2018 Oct;79(4):689-95.[Abstract]
50. Zhao H, Shu G, Wang S. The risk of non-melanoma skin cancer in HIV-infected patients: new data and meta-analysis. Int J STD AIDS. 2016 Jun;27(7):568-75.[Abstract]
51. Olsen CM, Knight LL, Green AC. Risk of melanoma in people with HIV/AIDS in the pre- and post-HAART eras: a systematic review and meta-analysis of cohort studies. PLoS One. 2014;9(4):e95096.[Abstract][Full Text]
52. Silverberg MJ, Chao C, Leyden WA, et al. HIV infection, immunodeficiency, viral replication, and the risk of cancer. Cancer Epidemiol Biomarkers Prev. 2011 Dec;20(12):2551-9.[Abstract][Full Text]
53. Yanik EL, Hernández-Ramírez RU, Qin L, et al. Brief Report: Cutaneous melanoma risk among people with HIV in the United States and Canada. J Acquir Immune Defic Syndr. 2018 Aug 15;78(5):499-504.[Abstract][Full Text]
54. Goldstein RH, DeCaprio JA. Merkel cell carcinoma in the HIV-1/AIDS patient. Cancer Treat Res. 2019;177:211-29.[Abstract]
55. Panou E, Nikolaou C, Payagala S, et al. HIV-related merkel cell carcinoma: a report of three cases from the UK. Int J STD AIDS. 2022 Sep 13 [epub ahead of print].[Abstract]
56. Tetzlaff MT, Nosek C, Kovarik CL. Epstein-Barr virus-associated leiomyosarcoma with cutaneous involvement in an African child with human immunodeficiency virus: a case report and review of the literature. J Cutan Pathol. 2011 Sep;38(9):731-9.[Abstract]
57. Yin X, Wu T, Yan Y, et al. Treatment for leiomyosarcoma and leiomyoma in children with HIV infection. Cochrane Database Syst Rev. 2010 May 12;(5):CD007665.[Abstract][Full Text]
58. Mittmann N, Knowles SR, Koo M, et al. Incidence of toxic epidermal necrolysis and Stevens-Johnson syndrome in an HIV cohort: an observational, retrospective case series study. Am J Clin Dermatol. 2012 Feb 1;13(1):49-54.[Abstract]
59. Creamer D, Walsh SA, Dziewulski P, et al. UK guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults 2016. Br J Dermatol. 2016 Jun;174(6):1194-227.[Abstract][Full Text]
60. Wang L, Varghese S, Bassir F, et al. Stevens-Johnson syndrome and toxic epidermal necrolysis: a systematic review of PubMed/MEDLINE case reports from 1980 to 2020. Front Med (Lausanne). 2022 Aug 24;9:949520.[Abstract][Full Text]
61. Maurer TA. Dermatologic manifestations of HIV infection. Top HIV Med. 2005;13(5):149-54.[Abstract]
62. Lapinski, TW, Parfieniuk A, Rogalska-Plonska M, et al. Prevalence of cryoglobulinaemia in hepatitis C virus- and hepatitis C virus/human immunodeficiency virus-infected individuals: implications for renal function. Liver Int. 2009 Sep;29(8):1158-61.[Abstract]
63. Brandariz D, Smithson A, Anton-Vazquez V. Drug reaction with eosinophilia and systemic symptoms related to antiretroviral treatment in human immunodeficiency virus patients. Indian J Sex Transm Dis AIDS. 2017 Jul-Dec;38(2):163-70.[Abstract][Full Text]
64. Rajendran PM, Dolev JC, Heaphy MR, Jr., et al. Eosinophilic folliculitis: before and after the introduction of antiretroviral therapy. Arch Dermatol. 2005 Oct;141(10):1227-31.[Abstract][Full Text]
65. Huiras E, Preda V, Maurer T, et al. Cutaneous manifestations of immune reconstitution inflammatory syndrome. Curr Opin HIV AIDS. 2008 Jul;3(4):453-60.[Abstract]
66. Kreuter A, Brockmeyer NH, Altmeyer P, et al. Anal intraepithelial neoplasia in HIV infection. J Dtsch Dermatol Ges. 2008 Nov;6(11):925-34.[Abstract]
67. Sasco AJ, Jaquet A, Boidin E, et al. The challenge of AIDS-related malignancies in sub-Saharan Africa. PLoS One. 2010 Jan 11;5(1):e8621.[Abstract][Full Text]
68. Almagro M, Del Pozo J, Garcia-Silva J, et al. Eyelash length in HIV-infected patients. AIDS. 2003 Jul 25;17(11):1695-6.[Abstract]
69. Obuch ML, Maurer TA, Becker B, et al. Psoriasis and human immunodeficiency virus infection. J Am Acad Dermatol. 1992 Nov;27(5 Pt 1):667-73.[Abstract]
70. Parkin JM, Eales LJ, Galazka AR, et al. Atopic manifestations in the acquired immune deficiency syndrome: response to recombinant interferon gamma. Br Med J (Clin Res Ed). 1987 May 9;294(6581):1185-6.[Abstract][Full Text]
71. Gelfand JM, Rudikoff D. Evaluation and treatment of itching in HIV-infected patients. Mt Sinai J Med. 2001 Sep-Oct;68(4-5):298-308.[Abstract]
72. Wei F, Gaisa MM, D'Souza G, et al. Epidemiology of anal human papillomavirus infection and high-grade squamous intraepithelial lesions in 29,900 men according to HIV status, sexuality, and age: a collaborative pooled analysis of 64 studies. Lancet HIV. 2021 Sep;8(9):e531-43.[Abstract][Full Text]
73. Centers for Disease Control and Prevention (CDC). Revised surveillance case definition for HIV infection--United States, 2014. MMWR Recomm Rep. 2014 Apr 11;63(RR-03):1-10.[Abstract][Full Text]
74. Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187.[Abstract][Full Text]
75. Cohen PR, Grossman ME. Clinical features of human immunodeficiency virus-associated disseminated herpes zoster virus infection - a review of the literature. Clin Exp Dermatol. 1989 Jul;14(4):273-6.[Abstract]
76. Pahwa S, Biron K, Lim W, et al. Continuous varicella-zoster infection associated with acyclovir resistance in a child with AIDS. JAMA. 1988 Nov 18;260(19):2879-82.[Abstract]
77. Jacobson MA, Berger TG, Fikrig S, et al. Acyclovir-resistant varicella zoster virus infection after chronic oral acyclovir therapy in patients with the acquired immunodeficiency syndrome (AIDS). Ann Intern Med. 1990 Feb 1;112(3):187-91.[Abstract]
78. Linnemann CC, Jr., Biron KK, Hoppenjans WG, et al. Emergence of acyclovir-resistant varicella zoster virus in an AIDS patient on prolonged acyclovir therapy. AIDS. 1990 Jun;4(6):577-9.[Abstract]
79. Coffin SE, Hodinka RL. Utility of direct immunofluorescence and virus culture for detection of varicella-zoster virus in skin lesions. J Clin Microbiol. 1995 Oct;33(10):2792-5.[Abstract][Full Text]
80. Cooper DA, Gold J, Maclean P, et al. Acute AIDS retrovirus infection. Definition of a clinical illness associated with seroconversion. Lancet. 1985 Mar 9;1(8428):537-40.[Abstract]
81. Wantzin GR, Lindhardt BO, Weismann K, et al. Acute HTLV III infection associated with exanthema, diagnosed by seroconversion. Br J Dermatol. 1986 Nov;115(5):601-6.[Abstract]
82. Rustin MH, Ridley CM, Smith MD, et al. The acute exanthem associated with seroconversion to human T-cell lymphotropic virus III in a homosexual man. J Infect. 1986 Mar;12(2):161-3.[Abstract]
83. Tindall B, Barker S, Donovan B, et al. Characterization of the acute clinical illness associated with human immunodeficiency virus infection. Arch Intern Med. 1988 Apr;148(4):945-9.[Abstract]
84. Sinicco A, Palestro G, Caramello P, et al. Acute HIV-1 infection: clinical and biological study of 12 patients. J Acquir Immune Defic Syndr. 1990;3(3):260-5.[Abstract]
85. Hulsebosch HJ, Claessen FA, van Ginkel CJ, et al. Human immunodeficiency virus exanthem. J Am Acad Dermatol. 1990 Sep;23(3 Pt 1):483-6.[Abstract]
86. Kingston M, French P, Higgins S, et al. UK national guidelines on the management of syphilis 2015. Int J STD AIDS. 2016 May;27(6):421-46.[Abstract]
87. Janier M, Unemo M, Dupin N, et al. 2020 European guideline on the management of syphilis. J Eur Acad Dermatol Venereol. 2021 Mar;35(3):574-88.[Abstract][Full Text]
88. National Comprehensive Cancer Network. NCCN guideline: Kaposi sarcoma [internet publication].[Full Text]
89. Esser S, Schöfer H, Hoffmann C, et al. S1 guidelines for the Kaposi sarcoma. J Dtsch Dermatol Ges. 2022 Jun;20(6):892-904.[Abstract][Full Text]
90. Rosado FG, Itani DM, Coffin CM, et al. Utility of immunohistochemical staining with FLI1, D2-40, CD31, and CD34 in the diagnosis of acquired immunodeficiency syndrome-related and non-acquired immunodeficiency syndrome-related Kaposi sarcoma. Arch Pathol Lab Med. 2012 Mar;136(3):301-4.[Abstract][Full Text]
91. Maurer T, Ponte M, Leslie K. HIV-associated Kaposi's sarcoma with a high CD4 count and a low viral load. N Engl J Med. 2007 Sep 27;357(13):1352-3.[Abstract]
92. Mallal S, Phillips E, Carosi G, et al; PREDICT-1 Study Team. HLA-B*5701 screening for hypersensitivity to abacavir. N Engl J Med. 2008 Feb 7;358(6):568-79.[Abstract][Full Text]
93. Potthoff A, Brockmeyer NH, Gelbrich G, et al; Competence Center Cardiac Insufficiency and the Competence Network HIV/AIDS. Lipodystrophy: a sign for metabolic syndrome in patients of the HIV-HEART study. J Dtsch Dermatol Ges. 2010 Feb;8(2):92-8.[Abstract]
94. Falutz J, Mamputu JC, Potvin D, et al. Effects of tesamorelin (TH9507), a growth hormone-releasing factor analog, in human immunodeficiency virus-infected patients with excess abdominal fat: a pooled analysis of two multicenter, double-blind placebo-controlled phase 3 trials with safety extension data. J Clin Endocrinol Metab. 2010 Sep;95(9):4291-304.[Abstract][Full Text]
