The Dermatological Manifestations of HIV Infection in Ethnic Skin
It is well known that HIV infection is associated with an increased burden of dermatologic disease.1, 2 Some studies show that greater than 90% of HIV-positive people have skin-related complaints.1, 2 Taking into account that the scope of dermatology includes the skin, hair, nails, and mucosa, approximately a quarter of the conditions listed as AIDS-defining illnesses are dermatologic in nature (Table 1).3 Historically, dermatologists were among some of the first doctors to recognize AIDS as a distinct condition.
Dermatologic conditions may be the presenting manifestation of HIV infection, prompting testing, 2 or a marker for disease progression (Table 2).4 Patients may have unusual, more severe, or recalcitrant cases of common conditions (e.g., warts, seborrheic dermatitis) or present with diseases relatively unique to HIV infection (e.g., eosinophilic folliculitis, Kaposi’s sarcoma). In untreated patients, the type of dermatologic disease seen tends to have a pattern that correlates with CD4 count; however, the introduction of HAART in the mid-1990s changed the pattern of the conditions seen.5 Complications from HAART and other medicines used to treat HIV infection, such as lipodystrophy, added to the list of the many HIV-related cutaneous manifestations.
KeywordsHuman Papilloma Virus Herpes Zoster Dark Skin Seborrheic Dermatitis Dermatophyte Infection
- 2.McGrath E, Evans A, Masenga J, Fuller C. Skin diagnoses prompting serological testing for HIV: an 8-year retrospective analysis of HIV testing in a regional dermatology centre, Tanzania. J Am Acad Dermatol. 2005 Mar; 1322.Google Scholar
- 3.MMWR December 18, 1992/41(RR-17) 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults.Google Scholar
- 6.HIV Infection in the United States Household Population Aged 18–49 Years: Results from 1999–2006. hppt://cdc.gov/NCHS/data/databriefs/db04.htm. (Accessed April 13, 2008)Google Scholar
- 11.Miller M, Cespedes C, Vavagiakis P, Klein RS, Lowy FD. Staphylococcus aureus colonization in a community sample of HIV-infected and HIV-uninfected drug users. Staphylococcus aureus colonization in a community sample of HIV-infected and HIV-uninfected drug users. Eur J Clin Microbiol. Infect Dis. 2003 Aug; 22(8): 463–9. Epub 2003 Jul 18.PubMedCrossRefGoogle Scholar
- 16.Cherneskie T. Update and Review of the Diagnosis and Management of Syphilis, Region II STD/HIV Prevention Training Center; New York City Department of Health and Mental Hygiene, New York: 2006.Google Scholar
- 21.Smith KJ, Skelton HG, Yeager J, Ledsky R, McCarthy W, Baxter D, et al. Cutaneous findings in HIV-1-positive patients: a 42 month prospective study. Military Medical Consortium for he Advancement of Retroviral Research (MMCARR). J Am Acad Dermatol. Nov 1994; 31(5 pt 1): 746–54.PubMedCrossRefGoogle Scholar
- 32.Mellanby K. Scabies. 2nd ed. Hampton, Middlesex, UK: E.W. Ltd; 1972: 1–81.Google Scholar
- 37.Dube M, Parker R, Tebas P, Grinspoon S, Zackin R, Robbins G, Roubenoff R, Shafer R, Wininger D, Meyer W, Snyder S, Mulligan K. Glucose metabolism, lipid, and body fat changes in antiretroviral-naïve subjects randomized to nelfinavir or efavirenz plus dual nucleosides. AIDS. 19(16): 1807–1818, November 4, 2005.PubMedCrossRefGoogle Scholar
- 39.Balasubramanyam A. “HIV-associated lipodystrophy syndrome: an accelerated form of the metabolic syndrome of insulin resistance due to altered fat distribution”. Research Initiative/Treatment Action!. Fall 2006. Find Articles.com. 24 May, 2008.Google Scholar
- 40.Lafeuillade A, Clumeck N, Mallolas J, Jaeger H, Livrozet J-M, Ferreira M, Johnson M, Cheret A, Antoun Z. Comparison of metabolic abnormalities and clinical lipodystrophy 48 weeks after switching from HAART to Trizivir TM versus continued HAART: The Trizal study. HIV Clin Trials. 2003; 4(1): 37–43.PubMedCrossRefGoogle Scholar
- 41.Fisher AM, Moyle G, Ebrahimi R, and others (SWEET Study Group). Switching from Combivir (CBV, AZT/3TC) to Truvada (TVD, TDF/FTC) Maintains Viral Suppression, Prevents and Reverses Limb Fat Loss, and Improves Biochemical Parameters: Results of a 48 Week Randomised Study. 11th European AIDS Conference (EACS). Madrid, Spain. October 24–27, 2007. Abstract PS5/7.Google Scholar
- 42.Taylor SC, Callendar VD, Burgess CM. Assessment of Adverse Experiences, keloid formation, and pigmentary changes in subjects with Fitzpatrick skin types IV, V or VI injected with hyaluronic acid gel dermal fillers. Presented November 11, 2007 at the LOreal 4th International Symposium, Ethnic Hair & Skin: Defining the Research Agenda in Miami, Fl.Google Scholar
- 46.HIV Infection in the United States Household Population Aged 18–49 Years: Results from 1999–2006. http://cdc.gov/NCHS/data/databriefs/db04.htm. Accessed April 13, 2008.