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Cutaneous Manifestations of Aids

»	How significant is the occurrence of skin disease in the setting of HIV infection?
»	Outline the clinical spectrum of cutaneous disease associated with HIV infection.
»	What are the most common dermatoses associated with HIV infection?
»	Can mucocutaneous changes occur as a result of primary HIV infection?
»	What is the most common bacterial pathogen in HIV disease? How does it manifest itself?
»	What is the most common cutaneous malignancy in HIV disease?
»	What are the cutaneous clinical features of epidemic Kaposi’s sarcoma?
»	How is Kaposi’s sarcoma treated?
»	Is the course of syphilis altered in HIV-infected individuals?
»	How does syphilis increase the risk for HIV infection?
»	What is oral hairy leukoplakia?
»	Name the four types of oropharyngeal candidiasis that can be seen in HIV disease.
»	What is HIV-associated eosinophilic folliculitis?
»	Is the incidence of drug eruptions increased in HIV disease?
»	Describe clinical features of molluscum contagiosum infection in the HIV-infected host.
»	How is molluscum contagiosum treated?
»	Is the prevalence of common and genital warts increased in HIV infection?
»	What causes bacillary angiomatosis?
»	How does varicella-zoster virus infection present in the HIV-positive patient?
»	Do any photosensitive dermatoses occur in HIV disease?
»	What is known about granuloma annulare in the setting of HIV infection?
»	Describe some of the potential cutaneous side effects of antiretroviral therapy.
»	What is the immune restoration syndrome?

What are the most common dermatoses associated with HIV infection?

Seborrheic dermatitis. Erythematous patches with yellow scale are present on the forehead, nose, and paranasal areas of an HIV-positive patient. (Courtesy of James E. Fitzpatrick, MD.)

Fig. 39.1 Seborrheic dermatitis. Erythematous patches with yellow scale are present on the forehead, nose, and paranasal areas of an HIV-positive patient. (Courtesy of James E. Fitzpatrick, MD.)

Papulosquamous dermatoses are among the most commonly seen cutaneous manifestations of HIV infection, and these include seborrheic dermatitis (Fig. 39-1) and xerosis. Other common dermatologic conditions include bacterial infections, such as Staphylococcus aureus skin infections. Fungal infections, such as mucocutaneous candidiasis (oropharyngeal and vulvovaginal) and dermatophytosis (tinea pedis, tinea cruris, tinea manuum, and onychomycosis), are also commonly encountered. Frequently seen viral infections include human papilloma virus infections (condyloma acuminata, common and plantar warts), as well as infections with herpes simplex virus, varicella-zoster virus, molluscum contagiosum, and Epstein-Barr virus (oral hairy leukoplakia).