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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 immune restoration syndrome?

Immune restoration syndrome (IRS) is also known as immune reconstitution syndrome, immune reactivation syndrome, and immune reconstitution inflammatory syndrome. It consists of the paradoxical recrudescence of quiescent disease or the appearance of new internal and cutaneous diseases that are temporally associated within weeks to months of HAART initiation. New or recurrent skin disease may consist of initial or recurrent herpes zoster, eosinophilic folliculitis, erythema nodosum with pulmonary sarcoidosis with or without cutaneous sarcoidosis, extensive cytomegalovirus ulceration, reactions to prior tattoos, disseminated cutaneous M. avium complex infection, alopecia universalis and Graves’ disease, and leprosy complicated by type 1 reactional state. The IRS is attributed to the immunologic recovery produced by HAART, with restoration of pathogen-specific immunity.

Hirsch HH, Kaufmann G, Sendi P, et al: Immune reconstitution in HIV-infected patients, CID 38:1159–1166, 2004.