In acute primary HIV infection, a rash may develop along with a mononucleosis-like illness. The rash may be exanthematous or pityriasis rosea-like, usually does not itch, is distributed over the upper trunk and proximal limbs, and may involve palms and soles. An associated enanthem of oral erythema or superficial erosions may be present. The exanthem [...]
Superficial cutaneous infection with human papillomavirus (HPV) occurs with increased frequency in immunosuppressed patients. The warts seldom cause symptoms, except when on the soles of the feet and around the fingernails.
Relapse of warts after treatment is common, especially in advanced HIV disease. Liquid nitrogen cryotherapy can be applied every 2 to 4 weeks. Topical “anti-wart” [...]
Molluscum contagiosum is a superficial cutaneous viral infection manifesting as 2- to 3-mm flesh-colored hemispheric papules. A faint whitish core usually is visible at the center of each papule, some of which may be slightly umbilicated. This eruption is seen commonly in immunocompetent young children (ages 3 to 8 years), whose lesions are scattered widely [...]
Varicella zoster virus (VZV) infection is commonly seen early in the course of HIV infection.
This dermatomal eruption may be particularly bullous, hemorrhagic, necrotic, and painful in HIV-infected persons. The duration of blisters and crusts is usually 2 or 3 weeks.
Dissemination of VZV in HIV infection is uncommon. The clinical manifestations of disseminated VZV infection include [...]
Chronic persistent infection with herpes simplex virus (HSV) is common in patients with advanced HIV disease and is a Centers for Disease Control (CDC)-defined index infection in establishing an AIDS diagnosis.
Lesions may appear as grouped blisters that rupture, crust, and heal in 7 to 10 days. Once severely immunosuppressed, HIV-infected persons often experience chronic lesions [...]
Bacillary angiomatosis
Bacillary angiomatosis is an infection caused by two species of Bartonella - B. henselae and B. quintana. These bacteria are extremely difficult to culture. One of the agents causing bacillary angiomatosis, B. henselae, is associated with cat scratch disease. Cat exposure and cat scratches are risk factors for acquiring bacillary angiomatosis.
Visceral disease may include [...]
Infectious cutaneous conditions
Staphylococcus aureus infections
Staphylococcus aureus is the most common bacterial skin infection in persons with HIV disease.
Bullous impetigo. Bullous impetigo is most common in hot, humid weather, presenting as very superficial blisters or erosions, most commonly seen in the groin or axilla.
Ecthyma is an eroded or superficially ulcerated lesion with an adherent crust. Purulent [...]
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