HIV/AIDS and Skin Conditions
Skin conditions are common in people with HIV/AIDS. Many, including Kaposi sarcoma, thrush, and herpes, are caused by germs that take advantage of a weakened immune system. That's why they are called "opportunistic" infections. Others, like photodermatitis, may be linked to inflammation caused by an overactive immune system as it revives during antiretroviral medicine therapy or due to the medicines themselves.
Here are some of the more common skin conditions related to HIV/AIDS.
This is a highly contagious viral skin infection that may be passed from person to person through skin-to-skin contact, by sharing linens, or by simply touching the same objects. Molluscum contagiosum causes pink or flesh-colored bumps on the skin. In people with HIV/AIDS, an outbreak of more than 100 bumps can happen.
Although the bumps are generally harmless, they won't go away without treatment if you have AIDS. Your healthcare provider may choose to freeze off the bumps with liquid nitrogen (cryosurgery) or destroy them with a laser or topical ointment. The treatment will generally be repeated every 6 weeks or so until they're gone.
Several types of herpes viruses are common in people with AIDS. Herpes simplex viral infections cause an outbreak of sores around the genital area or the mouth. Herpes zoster viral infection is caused by the same virus that causes chickenpox. It can also result in shingles. This is an extremely painful blistering rash on one side of the body. Herpes viral infections are often treated with antiviral medicines. Virtually all herpes viruses can become "latent." This means that even after the infection seems to clear, the virus remains in the body and can cause a new infection later on.
This is a type of cancer that starts in the cells that line the lymph or blood vessels. Kaposi sarcoma causes dark lesions on the skin. These may appear as brown, purple, or red patches or nodules. Kaposi sarcoma may also cause the skin to swell. The lesions can affect organs, too, including the lungs, liver, and parts of the digestive tract, where they can cause potentially life-threatening symptoms and breathing problems.
The skin condition typically only happen when your CD4 lymphocyte (also called T4 cell) count is extremely low. This means that your immune system is severely weakened. This condition is characteristic of AIDS. When someone with HIV develops Kaposi sarcoma or any other opportunistic infection, the official diagnosis changes to AIDS. When someone with HIV develops Kaposi sarcoma or any other opportunistic infection, the official diagnosis changes to AIDS. Highly active antiretroviral medicines have greatly reduced the incidence of Kaposi sarcoma and can help treat it if it develops. This cancer also generally responds to radiation, surgery, and chemotherapy.
Oral hairy leukoplakia
This is a viral infection that affects the mouth. It can cause thick, white lesions on the tongue that look hairy. It is particularly common in people with AIDS who have an extremely weakened immune system. Oral hairy leukoplakia doesn't need specific treatment, but effective treatment of HIVS/AIDS with antiretroviral medicines can improve your immune system and help to clear up the infection.
Oral candidiasis, also known as thrush, is a fungal infection that causes a thick white layer to form on the tongue or inner cheeks. Thrush can be managed with antifungal medicines, mouth lozenges, and mouth rinses. It is quite common in people with AIDS and can be difficult to treat, because the infection tends to come back. Taking effective HIV medicine usually improves this condition.
This is a skin condition in which the skin reacts to exposure to the sun by turning darker in color. It's most common in people of color, but anyone with HIV is susceptible to photodermatitis. If you're taking medicines to improve immune strength, you may temporarily have this reaction as a side effect. Protecting the skin from the sun is usually the strategy used to reduce photodermatitis.
This skin condition involves outbreaks of itchy, crusted lumps on the skin. The itching can be intense and severe. Prurigo nodularis is most common with extremely weakened immune systems, as well as among people of color with HIV/AIDS. Topical steroid treatment (lotions or creams put right on the skin) and managing HIV/AIDS with antiretroviral medicines are used to treat the condition.
Antiretroviral medicines can help prevent and manage most of these types of skin conditions. Other skin conditions may be triggered by the treatment and require other treatments. Talk with your healthcare provider about the best therapy for your particular skin condition.
March 22, 2017
Selecting Antiretroviral Regimens for the Treatment Naive HIV-infected Patient. UpToDate
Lentnek, Arnold, MD,Sather, Rita, RN