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INFECTIOUS CUTANEOUS MANIFESTATION OF HIV
PRESENTER ANDREA.R.SALINS
OVERVIEW
Cutaneous manifestation of HIV disease may be due to HIV infection itself or due to opportunistic infection secondary to decline in immuno competence from the disease.
It is very important to diagnose cutaneous manifestation so that appropriate antiretroviral therapy can be given.
CLASSIFICATION
VIRAL FUNGAL-------a) superficial b) deep BACTERIAL PARASITIC
VIRAL
HERPES SIMPLEX AND HERPES ZOSTER VIRUS Recurrent oral and anogenital HSV infection is common
in HIV patients and may lead to chronic ulceration. In normal individuals lesions heal within 7-10 days but
takes longer time in HIV patients.
VARICELLA ZOSTER VIRUS-unlike normal vesicles here there may be bullous,hemorrhagic,necrotic lesions healing with intense scar formation.This dermatomal scarring is characteristic feature in HIV patients.
HSV INFECTION
VZV INFECTION
EPSTEIN BARR VIRUS Implicated in pathogenesis of oral hairy
leukoplakia which may develop in HIV patients.
Filiform white papules located on sides of tongue.
Confused for lichen planus or oral candidiasis.
CYTOMEGALOVIRUS DNA virus of herpesviridae family. Ulcers in perianal region are most common
presentation of CMV infection in HIV patients.
HUMAN PAPILLOMA VIRUS Widespread warts observed in oral
mucosa,face,perianal and female genital tract in HIV infected individuals.
MOLLUSCUM CONTAGIOSUM DNA virus of poxviridae family. Small papules with central umblication. In HIV patients it may be widespread and
atypical.
MOLLUSCUM CONTAGIOSUM
MOLLUSCUM CONTAGIOSUM
FUNGAL SUPERFICIAL INFECTIONS Recurrent and persistent mucocutaneous
candidiasis is common. In adults,Tinea capitis,Tinea versicolor
infections are seen recurrently.
DEEP INFECTIONS Rarely cutaneous Cryptococcosis may be
seen which manifest as-cellulitis,papules,ulcers,plaques etc.
Pearly translucent papules similar to molluscum infection.
Cutaneous histoplasmosis may cause red papules.
ORAL CANDIDIASIS
BACTERIAL
MYCOBACTERIAL INFECTION M.tuberculosis,M.avium complex(MAC) infection
may present as acneiform papules and indurated crusted plaques.
Primary cutaneous infection by MAC is rare.Mostly due to dissemination.
Cutaneous manifestation so far reported are: -verrucous ulcers -scaling plaques -pustular lesion -crusted ulcers -draining sinuses -inflammatory nodules
SYPHILIS Co infection with syphilis can be seen in HIV
patients. Primary syphilis presents with multiple ulcers
in HIV patients.
STAPHYLOCOCCUS AUREUS INFECTION
Patients with HIV have been found to have increased cutaneous colonization of S.aureus.
Presents as-bullous impetigo -folliculitis
Bullous impetigo Folliculitis
PARASITIC
Scabies characterised by widespread hyperkeratotic,scaly,maculopapular,eruption or crusted plaques can occur in HIV infected patients.
Atypical Leishmaniasis have been reported.