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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?

Name the four types of oropharyngeal candidiasis that can be seen in HIV disease.

Oral changes. A, Oral hairy leukoplakia. Vertically oriented white plaques with a corrugated appearance are seen on the lateral edge of the tongue. B, Hyperplastic candidiasis. A white coating that does not scrape off is present on the dorsal surface of the tongue in this HIV-positive patient.

Fig. 39.3 Oral changes. A, Oral hairy leukoplakia. Vertically oriented white plaques with a corrugated appearance are seen on the lateral edge of the tongue. B, Hyperplastic candidiasis. A white coating that does not scrape off is present on the dorsal surface of the tongue in this HIV-positive patient.

Pseudomembranous candidiasis appears as whitish, cottage-cheese–like or creamy plaques at any site in the oropharynx. These are removable when scraped and may leave a reddish surface. Erythematous candidiasis appears as well-demarcated patches of erythema on the palate or dorsal tongue. Lesions of erythematous candidiasis on the tongue can look smooth and depapillated. Hyperplastic candidiasis appears as a white coating on the dorsum of the tongue that persists with scraping (Fig. 39-3B). Angular cheilitis consists of erythema, cracking, and fissuring of the mouth corners. More than one type of oropharyngeal candidiasis can coexist.