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Cutaneous Manifestations of Aids

»	How significant is the occurrence of skin disease in the setting of HIV infection?
»	Outline the clinical spectrum of cutaneous disease associated with HIV infection.
»	What are the most common dermatoses associated with HIV infection?
»	Can mucocutaneous changes occur as a result of primary HIV infection?
»	What is the most common bacterial pathogen in HIV disease? How does it manifest itself?
»	What is the most common cutaneous malignancy in HIV disease?
»	What are the cutaneous clinical features of epidemic Kaposi’s sarcoma?
»	How is Kaposi’s sarcoma treated?
»	Is the course of syphilis altered in HIV-infected individuals?
»	How does syphilis increase the risk for HIV infection?
»	What is oral hairy leukoplakia?
»	Name the four types of oropharyngeal candidiasis that can be seen in HIV disease.
»	What is HIV-associated eosinophilic folliculitis?
»	Is the incidence of drug eruptions increased in HIV disease?
»	Describe clinical features of molluscum contagiosum infection in the HIV-infected host.
»	How is molluscum contagiosum treated?
»	Is the prevalence of common and genital warts increased in HIV infection?
»	What causes bacillary angiomatosis?
»	How does varicella-zoster virus infection present in the HIV-positive patient?
»	Do any photosensitive dermatoses occur in HIV disease?
»	What is known about granuloma annulare in the setting of HIV infection?
»	Describe some of the potential cutaneous side effects of antiretroviral therapy.
»	What is the immune restoration syndrome?

What is the most common bacterial pathogen in HIV disease? How does it manifest itself?

Staphylococcus aureus is the most common cutaneous bacterial pathogen in HIV disease. Cutaneous infections due to S. aureus most commonly present as a superficial folliculitis. Less common manifestations include impetigo, ecthyma, furunculosis, cellulitis, abscesses, and botryomycosis. In addition, S. aureus can secondarily infect underlying primary dermatoses such as eczema, scabies, herpetic ulcers, and Kaposi’s sarcoma, or can colonize intravenous catheter sites. Staphylococcal colonization (carriage) of the nose and flexures (perineal, toe webspaces) is known to increase in HIV disease and may account for the increased incidence of cutaneous infections. As in the general population, infections with community-acquired methicillin-resistant S. aureus (MRSA) are becoming increasingly common.

Ahuja D, Albrecht H: HIV and community-acquired MRSA, AIDS Clin Care 21:21–23, 2009.