HIV-Infection and Associated Dermatoses

  • Baraka M. Chaula


The skin as the largest body organ is an important marker for an underlying HIV infection. There is a broad spectrum of skin symptoms and diseases that can be seen arising as a result of the underlying infection and progressing severity of the disease, enabling the dermatologist to make early diagnosis. Depending on the immune status of the patient, various cutaneous manifestations occur. While the majority of them improve as the immune status stabilizes, some may present a paradox by either worsening or clinically becoming more apparent. Drugs used to treat HIV, such as the highly active antiretroviral therapy (HAART), can themselves lead to significant side effects that manifest on the skin.


  1. 1.
    UNAIDS. AIDS by the numbers, AIDS is not over, but it can be. 2016. Google Scholar
  2. 2.
    Ameen M. Impact of human immunodeficiency virus-related disease on pigmented skin types. Br J Dermatol. 2013;169(suppl 3):11–8.CrossRefPubMedGoogle Scholar
  3. 3.
    Wernham AG, Vydianath B, Chua SL. Thalidomide-A novel therapeutic approach for pruritic papular eruption of HIV. JAAD Case Rep. 2015;1:109–11.CrossRefPubMedCentralPubMedGoogle Scholar
  4. 4.
    Resneck JS, VanBeek M. Fumanski et al: etiology of pruritic popular eruption with HIV infection in Uganda. JAMA. 2004;292:2614–21.CrossRefPubMedGoogle Scholar
  5. 5.
    Chua SL, Amerson EH, Leslie KS, et al. Factors associated with pruritic papular eruption of human immunodeficiency virus infection in the antiretroviral therapy era. Br J Dermatol. 2014;170:832–9.CrossRefPubMedCentralPubMedGoogle Scholar
  6. 6.
    Forrestel AK, Kovarick CL, Mosam A, et al. Diffuse HIV-associated seborrheic dermatitis-a case series. Int J STD AIDS. 2016;27:1342–5.CrossRefPubMedGoogle Scholar
  7. 7.
    Bilu D, Mamelak AJ, Nguyen RH, et al. Clinical and epidemiologic characterization of photosensitivity in HIV positive individuals. Photodermatol Photoimmunol Photomed. 2004;20:175–83.CrossRefPubMedGoogle Scholar
  8. 8.
    Anthony FC, Marsden RA. Vitiligo in association with human immunodeficiency virus infection. J Eur Acad Dermatol Venereol. 2003;17:456–8.CrossRefGoogle Scholar
  9. 9.
    Mischo M, von Kobyletzki LB, Brundermann E, et al. Similar appearance, different mechanisms: xerosis in HIV, atopic dermatitis and ageing. Exp Dermatol. 2014;23:446–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Meys R, Gotch FM, Bunker CB. Human papilloma virus in the era of highly antiretroviral therapy for human immunodeficiency virus: an immune reconstitution-associated disease? Br J Dermatol. 2010;162:6–11.CrossRefPubMedGoogle Scholar
  11. 11.
    Mapesi H, Ramirez A, Tanner M, et al. Immune reconstitution inflammatory syndrome associated with dermatophytes in two HIV-1 positive patients in rural Tanzania: case report. BMC Infect Dis. 2016;16:495.CrossRefPubMedCentralPubMedGoogle Scholar
  12. 12.
    Govender NP, Maphanga TG, Zulu TG, et al. An outbreak of lymphocutaneous sporotrichosis among mine-workers in South Africa. PLoS Negl Trop Dis. 2015;9:e0004096.CrossRefPubMedCentralPubMedGoogle Scholar
  13. 13.
    Bonifaz A, Chang P, Moreno K, et al. Disseminated histoplasmosis in acquired immunodeficiency syndrome: report of 23 cases. Clin Exp Dermatol. 2009;34:481–6.CrossRefPubMedGoogle Scholar
  14. 14.
    Forrestel AK, Naujokas A, Martin JN, et al. Bacillary angiomatosis masquerading as Kaposi’s sarcoma in East Africa. J Int Assoc Provid AIDS Care. 2015;14:21–5.CrossRefPubMedGoogle Scholar
  15. 15.
    Farhi D, Zizi N, Grange P, et al. The epidemiology and clinical presentation of syphilis in a venereal disease center in Paris, France: a cohort study of 284 consecutive cases over the period of 2000-2007. Eur J Dermatol. 2009;19:484–9.PubMedGoogle Scholar
  16. 16.
    Stevenson J, Health M. Syphilis and HIV infection: an update. Dermatol Clin. 2005;24:497–507.CrossRefGoogle Scholar
  17. 17.
    Guarneri C, Tchernev G, Bevelacqua V, et al. The unwelcome trio: HIV plus cutaneous and visceral leishmaniasis. Dermatol Ther. 2016;29(2):88–91. series: Int J STD AIDS 2016; 27: 1342–45.Google Scholar
  18. 18.
    Birbal S, Dheda M, Ojewole E, et al. Adverse drug reactions associated with antiretroviral therapy in South Africa. Afr J AIDS Res. 2016;15:243–8.PubMedGoogle Scholar
  19. 19.
    Stewart A, Lehloenya R, Boulle A, et al. Severe antiretroviral-associated skin reactions in south African patients: a case series and case control analysis. Pharmacoepidemiol Drug Saf. 2016;25:1313–9.CrossRefPubMedGoogle Scholar
  20. 20.
    Rodriguez O, Kovarick CL. Spectrum and progression of disease from condyloma to aggressive anogenital squamous cell carcinoma in 3-HIV-positive patients. JAAD Case Rep. 2016;2:47–50.CrossRefPubMedCentralPubMedGoogle Scholar
  21. 21.
    Picard A, Badoual C, Hoursean M, et al. Human papilloma virus prevalence in HIV patients with head and neck squamous cell carcinoma. AIDS. 2016;30:1257–66.CrossRefPubMedGoogle Scholar
  22. 22.
    Thomas JO. Acquired immunodeficiency syndrome-associated cancers in sub-Saharan Africa. Semin Oncol. 2001;28:198–206.CrossRefPubMedGoogle Scholar
  23. 23.
    Namakoola I, Wakeham K, Parkes-Ratanshi R, et al. Use of nail and oral pigmentation to determine ART eligibility among HIV-infected Ugandan adults. Tropical Med Int Health. 2010;15:259–62.CrossRefGoogle Scholar
  24. 24.
    Nikolic DS, Vierro D, Tije VC, et al. Alopecia universalis associated with vitiligo in an 18-year old HIV-positive patient: highly active anti-retroviral therapy as first choice therapy? Acta Derm Venereol. 2014;94:116–7.CrossRefPubMedGoogle Scholar
  25. 25.
    Price P, Mathiot N, Krueger R, et al. Immune dysfunction and immune restoration disease in HIV patients given highly active antiretroviral therapy. Clin Infect Dis. 2002;34:224–33.CrossRefGoogle Scholar
  26. 26.
    Gromley RH, Kovarick CL. Human papillomavirus-related genital disease in the immunocompromised host. J Am Acad Dermatol. 2012;66:867–99.Google Scholar
  27. 27.
    Centers for Disease Control and Prevention, Workworski KA, Berman SM. Sexually transmitted diseases treatment guidelines 2006. MMWR Recomm Rep. 2006;55:62–7.Google Scholar
  28. 28.
    Lohloenya R, Meintjes G. Dermatological manifestations of the immune reconstitution inflammatory syndrome. Dermatol Clin. 2006;24:549–70.CrossRefGoogle Scholar
  29. 29.
    Sen S Bhaumik P. Resolution of giant molluscum contagiosum with antiretroviral therapy. Indian J Dermatol Venereol Leprol. 2008;74:267–8.CrossRefPubMedGoogle Scholar
  30. 30.
    Bar A, Hautschke D, Mirmohammadsadegh A, et al. Spectrum of bacterial isolates in HIV-positive patients with skin and soft tissue infections: emergence of methicillin-resistant staphylococci. AIDS. 2003;17:1253–6.CrossRefPubMedGoogle Scholar
  31. 31.
    Tappero JW, Perkins BA, Wenger JD, et al. Cutaneous manifestations of opportunistic infections in patients infected with human immunodeficiency virus. Clin Microbiol Rev. 1995;8:440–50.PubMedPubMedCentralGoogle Scholar
  32. 32.
    WHO. Consolidated guidelines on: The Use of Antiretroviral Drugs for Treating and Preventing HIV Infection; recommendations for a public health approach, 2nd edition. 2016. ISBN:9789241549684.Google Scholar
  33. 33.
    Sundar S, Sinha PK, Rai M, et al. Comparison of short course multidrug treatment with standard therapy for visceral leishmaniasis in India: an open-label, non-inferiority randomized controlled trial. Lancet. 2011;377(9764):477–86.CrossRefPubMedGoogle Scholar
  34. 34.
    Navarini AA, Stoeckle MM, Navarini S, et al. Antihistamines are superior to topical steroids in managing human immunodeficiency virus (HIV)-associated papular pruritic eruption. Int J Dermatol. 2010;49:83–8.CrossRefPubMedGoogle Scholar
  35. 35.
    Siegfried N, Uthman OA, Rutherford GW. Optimal time for initiation of antiretroviral therapy in asymptomatic, HIV-infected, treatment-naive adults. Cochrane Database Syst Rev. 2010;3:CD008272.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Baraka M. Chaula
    • 1
  1. 1.Dermatology Unit, Department of Internal MedicineMbeya Zonal Referral HospitalMbeyaTanzania

Personalised recommendations