Dermatologic Manifestations of HIV

Aka: Dermatologic Manifestations of HIV, HIV Related Rash, HIV Related Dermatologic Complications, Pruritus in HIV, Common Skin Disorders in HIV

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II. Pathophysiology

  1. CD4 Count suppression is associated with HIV-related infectious and non-infectious skin conditions

III. Symptoms: Pruritus

  1. May be presentation without associated rash or Jaundice
  2. Other causes of Pruritus in HIV
    1. Scabies
    2. Dry Skin
    3. Psoriasis
    4. Sulfa Allergy
    5. Staphylococcal Folliculitis
    6. Liver failure with cholestasis

IV. Signs

  1. Early, Acute HIV (prior to Seroconversion)
    1. Transient, Macular, Roseolar rash on trunk
  2. Common dermatologic conditions in HIV
    1. Staphylococcus AureusSkin Infections (common)
      1. Bacterial Folliculitis
      2. Furuncle or abscess
      3. Cellulitis
    2. Skin Viral Infections (more severe than in non-HIV patients)
      1. Herpes Simplex Virus
      2. Herpes Zoster
      3. Monkeypox
      4. Human Papilloma Virus (HPV)
    3. Skin and mucous membrane Fungal Infections (common)
      1. Oral Candidiasis (Thrush)
      2. Dermatophytosis
      3. Onychomycosis
    4. Treatment resistant warts (despite modern Antiretroviral therapy)
      1. Verruca Vulgaris (Common Wart)
      2. Genital Warts
      3. Epidermodysplasia verruiformis
    5. Non-infectious common skin disorders
      1. Seborrheic Dermatitis (40 to 80% of HIV patients)
      2. Xerosis (40 to 80% of HIV patients)
      3. Psoriasis
      4. Alopecia
  3. Late HIV and AIDS
    1. Eosinophilic Folliculitis
    2. Bacillary Angiomatosis
    3. Kaposi's Sarcoma
    4. Drug Reaction in HIV
    5. Opportunistic Skin Infections
      1. Histoplasmosis
      2. Molluscum Contagiosum
      3. Oral Hairy Leukoplakia
      4. Norwegian crusted Scabies (severe Scabies)

V. Reference

  1. Jaqua (2026) Am Fam Physician 113(1): 71-9 [PubMed]
  2. Mathieu (April 2000) Federal Practitioner, p.18-28 [PubMed]

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