Non infectious cutaneous manifestations of HIV
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Transcript of Non infectious cutaneous manifestations of HIV
Non-Infectious Cutaneous
Manifestations Of HIV
-Reshma Ann Mathew
Disorders of epidermal cell kinetics- Seborrheic dermatitis, Psoriasis, Reiter’s
syndrome, Ichthyosiform dermatoses ( Xerosis )
Papular and follicular eruption of HIV- Pruritic Papular eruption
Pigmentary disorders- Hyperpigmentation, Vitiligo
Non Infectious Dermatoses
Adverse cutaneous drug reactions
Neoplasms- Kaposi’s sarcoma, lymphoma, melanoma
Miscellaneous dermatoses- Pityriasis rubra pilaris, idiopathic
thrombocytopenic purpura, pityriasis rosea, photosensitivity
Observed in 85% - It may be the initial cutaneous manifestation of HIV disease
Involves hairy region of scalp, face, axillae and pubic region.
Histologically- inflammatory changes & keratinocyte necrosis at dermoepidermal junction
Management-Topical steroids and oral Imidazoles (antifungal agents).
Seborrhoeic dermatitis
Pre-existing psoriasis may worsen and form guttate lesions, plaques or pustules or become erythrodermic.
Occur on extensor surfaces and scalp
Management-Standard topical therapy, systemic retinoids.
Psoriasis
Xerosis or Acquired Ichthyosis is frequently observed in more than 30% patients with HIV infection.
It is often accompanied by severe generalized itching.
Starts on the lower extremities
Histologically- hyperkeratosis with a thin granular layer
Ichthyosiform dermatoses
PPE is asso. with low CD4 count (<100 cells/pl)
It is characterized by marked pruritus and a greater involvement of the extremities than the trunk or face.
Clinically, the eruptions are follicular or non-follicular lesions (papules, pustules and nodules)
often with secondary change(excoriation, prurigo nodularis)
Pruritic papular eruption (PPE)
Cutaneous hyperpigmentation is frequently seen in late stage HIV
It is associated with oral pigmentation and involvement of palms.
Hyperpigmentation
It is high in untreated HIV and increasing immunodeficiency
The commom drug reaction patterns seen are-1) Toxic epidermis necrolysis(TEN), Steven
Johnson Syndrome(SJS)2) Genital and Oral ulcers 3) Systemic reactions, including fever,
leukopenia, thrombocytopenia, hepatitis, and nephritis
Adverse Cutaneous Drug reactions
It is the most common neoplastic complication of HIV
begins as pink macules that enlarge and become palpable.
They grow into purplish or brown plaques which may become hemorrhagic and nodular.
Common sites are trunk, leg, arm, face and oral cavity.
Kaposi sarcoma
Pityriasis rubra pilaris- characterized by reddish orange scaling,
plaques and keratotic follicular papules
Miscellaneous Dermatoses
Idiopathic thrombocytopenic purpura-
non palpable petechiae
Pityriasis rosea- malaise, fever with typical rash