INFECTIOUS CUTANEOUS MANIFESTATION OF HIV

PRESENTER ANDREA.R.SALINS

OVERVIEW

Cutaneous manifestation of HIV disease may be due to HIV infection itself or due to opportunistic infection secondary to decline in immuno competence from the disease.

It is very important to diagnose cutaneous manifestation so that appropriate antiretroviral therapy can be given.

CLASSIFICATION

VIRAL FUNGAL-------a) superficial b) deep BACTERIAL PARASITIC

VIRAL

HERPES SIMPLEX AND HERPES ZOSTER VIRUS Recurrent oral and anogenital HSV infection is common

in HIV patients and may lead to chronic ulceration. In normal individuals lesions heal within 7-10 days but

takes longer time in HIV patients.

VARICELLA ZOSTER VIRUS-unlike normal vesicles here there may be bullous,hemorrhagic,necrotic lesions healing with intense scar formation.This dermatomal scarring is characteristic feature in HIV patients.

HSV INFECTION

VZV INFECTION

EPSTEIN BARR VIRUS Implicated in pathogenesis of oral hairy

leukoplakia which may develop in HIV patients.

Filiform white papules located on sides of tongue.

Confused for lichen planus or oral candidiasis.

CYTOMEGALOVIRUS DNA virus of herpesviridae family. Ulcers in perianal region are most common

presentation of CMV infection in HIV patients.

HUMAN PAPILLOMA VIRUS Widespread warts observed in oral

mucosa,face,perianal and female genital tract in HIV infected individuals.

MOLLUSCUM CONTAGIOSUM DNA virus of poxviridae family. Small papules with central umblication. In HIV patients it may be widespread and

atypical.

MOLLUSCUM CONTAGIOSUM

MOLLUSCUM CONTAGIOSUM

FUNGAL SUPERFICIAL INFECTIONS Recurrent and persistent mucocutaneous

candidiasis is common. In adults,Tinea capitis,Tinea versicolor

infections are seen recurrently.

DEEP INFECTIONS Rarely cutaneous Cryptococcosis may be

seen which manifest as-cellulitis,papules,ulcers,plaques etc.

Pearly translucent papules similar to molluscum infection.

Cutaneous histoplasmosis may cause red papules.

ORAL CANDIDIASIS

BACTERIAL

MYCOBACTERIAL INFECTION M.tuberculosis,M.avium complex(MAC) infection

may present as acneiform papules and indurated crusted plaques.

Primary cutaneous infection by MAC is rare.Mostly due to dissemination.

Cutaneous manifestation so far reported are: -verrucous ulcers -scaling plaques -pustular lesion -crusted ulcers -draining sinuses -inflammatory nodules

SYPHILIS Co infection with syphilis can be seen in HIV

patients. Primary syphilis presents with multiple ulcers

in HIV patients.

STAPHYLOCOCCUS AUREUS INFECTION

Patients with HIV have been found to have increased cutaneous colonization of S.aureus.

Presents as-bullous impetigo -folliculitis

Bullous impetigo Folliculitis

PARASITIC

Scabies characterised by widespread hyperkeratotic,scaly,maculopapular,eruption or crusted plaques can occur in HIV infected patients.

Atypical Leishmaniasis have been reported.