HIV - Various cutaneous problems - Late clinical manifestations

A papulopruriginous to nodular skin rash occurs in about 10 % of the seropositive population in the tropics. The cause of this nodular prurigo is not known. The itching is sometimes intolerable and difficult to treat. The differential diagnosis includes scabies (also frequent and sometimes very severe) and onchocerciasis. One gets the impression that HIV positive persons react more violently and with more itching (pruritus) to various insect bites. Cutaneous rash - not necessarily with itching – can occur as a result of side-effects of medication (sulphamethoxazole, thiosemicarbazone). Symptomatic treatment is often the only treatment for itch. Seborrheic dermatitis is very frequent (3% in the general population, but up to 50% in AIDS patients). This seems to be connected with a reaction to the skin yeast Pityrosporon ovale. Immunodeficient persons often develop a chronic, refractory, extensive but quite benign skin infection with a pox virus: molluscum contagiosum. This results in numerous small umbilicated papules. Psoriatic skin lesions are frequently activated during HIV infection.

Category: Medical Subject Notes