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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?

How does varicella-zoster virus infection present in the HIV-positive patient?

Primary infection with the varicella-zoster virus (VZV, chickenpox) in HIV disease may be associated with complications such as pneumonia, encephalitis, hepatitis, profuse eruptions, and even death. Reactivation of latent VZV infection is increased in HIV disease. Reactivation usually manifests itself as a typical unidermatomal eruption, but with advanced immunodeficiency, multidermatomal and disseminated eruptions can occur. These eruptions may be vesiculobullous, hemorrhagic, necrotic, or poxlike and may be very painful. Chronic, painful verrucous and ecthymatous (poxlike) lesions can occur and appear as hyperkeratotic warty nodules and necrotic ulcerations, respectively.

Weinburg JM, Mysliwiec A, Turiansky GW, et al: Viral folliculitis: atypical presentations of herpes simplex, herpes zoster, and molluscum contagiosum, Arch Dermatol 133:983–986, 1997.