Cutaneous Manifestations
of AIDS
Dr. Ashraf AL-Sawy
There is no skin condition reported so far
that is specific for HIV infection.
During the course of HIV infection, skin
diseases tend to be:
– more chronic,
– more severe,
– more resistant to conventional treatments,
– and often display unusual clinical presentations.
HIV epidemic has brought to attention
previously rare skin diseases, such as
bacillary angiomatosis, Kaposis's sarcoma
and eosinophilic folliculitis.
ETIOLOGY OF AIDS
The first cases of AIDS occurred in the
USA in 1981.
AIDS is caused by the virus HIV.
HIV is part of a family or group of viruses
called lentiviruses.
Lentiviruses other than HIV have been
found in a wide range of nonhuman
primates and known collectively as simian
(monkey) viruses (SIV).
It is generally accepted that HIV is a
descendant of (SIV). Certain SIV bear a
very close resemblance to HIV-1 and HIV-
2, the two types of HIV.
It is claimed that
chimpanzees were the
source of HIV-1, and
that the virus at some
point crossed species
from chimpanzees to
human.
IMPORTANCE OF CUTANEOUS
MANIFESTATIONS
1. Cutaneous lesions are often the first
manifestation of HIV noted by patients and health
professionals.
2. Cutaneous lesions occur frequently in both
adults and children infected with HIV.
3. Prompt diagnosis and treatment of cutaneous
manifestations can prevent complications and
improve quality of life for HIV-infected persons.
TYPES OF CUTANEOUS
MANIFESTATIONS
Neoplasi
Kaposi’s sarcoma
Lymphoma
Squamous and basal cell carcinoma
Kaposi Sarcoma
red, purplish or brown
coloured macules,
nodules or plaque.
common sites are
trunk, legs, face and
oral cavity.
Infections
Viral Infections:
Herpes simplex infection.
Herpes zoster.
Molluscum contagiosum.
Human papilloma virus.
Herpes simplex
Oral and anogenital
herpes simplex virus
(HSV) infection is
common in HIV
disease.
recurrent self-healing
blistering eruption.
HSV infection become
persistent and
progressive.
Erosions enlarges and
deepen into painful,
non-healing ulcers.
Herpes Zoster
Herpes zoster is
common in HIV
patients.
In the majority of
cases the disease runs
typical course with a
vesicular eruption in a
dermatomal pattern.
Hemorragic and
necrotic lesions may
occur in young-
patients.
Severe haemorrhagic
and necrotic lesions
may extend over
several dermatomes,
or disseminated
allover the body.
Molluscum contagiosum
Individual lesions can
grow in size, up to 10
mm, and merge into
larger lesions that
become disfiguring
when located on the
face.
This is suggestive of
HIV.
Molluscum
contagiosum on the
face is unusal in
adults.
Widespread lesions
are common and
highly characteristic of
HIV disease.
Human Papilloma Virus
(HPV)
In HIV-infected individuals the incidence of
facial and intraoral warts is increased and
anogenital lesions may be florid.
Intra-epithelial carcinoma has been reported
to develop even without HPV types usually
associated with malignancy.
Superficial fungal infections
Angular cheilitis
Impetigo
Lymphogranuloma venereum
Mycobacterial infection
Syphilis
Folliculitis and Furunculosis
Staph aureus
T. corporis
Scabies
Others:
Pruritic papular eruption
Seborrhoeic dermatitis
Drug eruptions
Vasculitis
Xeroderma
Psoriasis
Thrombocytic purpura
Telangiectasis
Hyperpigmentation
Dry atrophic skin
Hair changes
Axillary seb.
dermatitis
Pruritic papular eruption
Thank You