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Human Immunodeficiency Virus (HIV)-Associated Dermatoses and Malignancy

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Hospital-Based Dermatopathology

Abstract

A large proportion of patients diagnosed with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) will develop cutaneous lesions over the course of their disease. The broad spectrum of disorders with skin involvement includes inflammatory and vesiculobullous dermatoses, infective conditions, adverse drug reactions, and neoplastic proliferations, some of which are AIDS-defining. The introduction of highly active antiretroviral therapy (HAART) and subsequently combination antiretroviral therapy (cART) has led to the emergence of the immune reconstitution inflammatory syndrome (IRIS), a condition which is frequently associated with cutaneous manifestations. Although many HIV-/AIDS-related skin disorders are largely a source of morbidity and can be readily managed on an outpatient basis, certain conditions are severe and potentially life-threatening, necessitating hospitalization. Dermatopathologists who are exposed to histologic specimens from the latter group of patients in particular are required to have a sound working knowledge of HIV-/AIDS-associated cutaneous pathology, and an integrated diagnostic approach. Detailed clinicopathologic correlation, which encompasses knowledge of the patient’s treatment status and CD4 T-cell count, is essential for accurate diagnosis. This chapter focuses primarily on the noninfective complications and dominant neoplastic proliferations associated with HIV/AIDS.

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Acknowledgments

The author gratefully acknowledges Dr. Karen Wolfowitz, formerly of the Division of Dermatology, University of the Witwatersrand, Johannesburg, for her clinical and pathogenetic insights into HIV-associated lichenoid photodermatitides.

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  1. School of Pathology, University of the Witwatersrand, Johannesburg, South Africa

    Wayne Grayson

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  1. Professor of Pathology, Harvard Medical School, Director of Dermatopathology, Massachusetts General Hospital, Boston, MA, USA

    Mai P. Hoang

  2. Professor of Pathology and Dermatology, Director, Dermatopathology Unit, Duke University Medical Center, Durham, NC, USA

    Maria Angelica Selim

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Grayson, W. (2020). Human Immunodeficiency Virus (HIV)-Associated Dermatoses and Malignancy. In: Hoang, M., Selim, M. (eds) Hospital-Based Dermatopathology. Springer, Cham. https://doi.org/10.1007/978-3-030-35820-4_18

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