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Skin Conditions Related to HIV/AIDS

What Is HIV/AIDS?

HIV (Human Immunodeficiency Virus) is the virus that causes AIDS (Acquired Immune Deficiency Syndrome). The virus weakens a person's ability to fight infections and cancer. People with HIV are said to have AIDS when the virus makes them very sick and they develop certain infections or cancers.

Because HIV weakens the immune system, people with AIDS are more likely to suffer health problems, including those of the skin. In fact, certain skin diseases may be the first sign that someone is infected with HIV.

While many people with HIV/AIDS may develop the following conditions, especially Kaposi's sarcoma (sometimes called KS), it is important to note that a person may have any one of these conditions but not have HIV/AIDS.

Thrush and HIV/AIDS

Thrush is an infection of the mouth caused by the candida fungus, a type of yeast. A common sign of thrush is the presence of creamy white, slightly raised lesions in your mouth -- usually on your tongue or inner cheeks -- but also sometimes on the roof of your mouth, gums, tonsils, or back of your throat. The lesions, which may have a "cottage cheese" appearance, can be painful and may bleed slightly when you scrape them or brush your teeth.

Candida infections can spread to other parts of the body, including the esophagus, lungs, liver, and skin. This happens more often in people with cancer, HIV, or other conditions that weaken the immune system. The symptoms may be more severe and difficult to manage in those with weakened immune systems.

To treat thrush, your doctor may prescribe antifungal medications (tablets, lozenges, or liquids), which are generally taken for 10 to 14 days.

Kaposi's Sarcoma and HIV/AIDS

Kaposi's sarcoma (KS) is a form of cancer that occurs on the skin and in mucous membranes. It occurs among people who have HIV/AIDS. It is related to a herpes type virus.

KS appears as purplish or dark lesions on the skin. Because of the weakened immune system caused by AIDS, KS can spread quickly to other parts of the body, including internal organs.

KS can be treated with surgery (cutting out the lesion and surrounding skin), chemotherapy (drugs that kill cancer cells), radiation therapy (high doses of X-rays or other radiation), or biologic therapy (using the body's own resources to boost the immune system). Treating HIV itself is usually the best treatment as it restores the immune system enough to cure the KS.

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Oral Hairy Leukoplakia As a Sign of HIV/AIDS

Oral hairy leukoplakia is an infection that appears in the mouth as white lesions on the bottom or sides of the tongue. Oral hairy leukoplakia may be one of the first signs of HIV/AIDS. The infection is caused by the Epstein-Barr virus.

Oral hairy leukoplakia lesions may be flat and smooth or raised and furry (hairy). The lesions do not cause pain or discomfort, so they are usually not treated. The condition resolves on its own, but can recur often. If necessary, oral hairy leukoplakia can be treated with acyclovir, a medication that treats herpes (see below).

HIV/AIDS and Molluscum Contagiosum

Molluscum contagiosum is an infection that is marked by smooth white or flesh-colored bumps on the skin. It is caused by a virus and is contagious.

This condition is not serious, and the bumps often resolve on their own without treatment. However, in people with HIV infection whose immune systems are functioning poorly, the infection can become very chronic and progressive. If necessary, the bumps can be removed by a doctor by scraping or freezing. Drug treatments may include retinoic acid or imiquimod cream. Again, the best treatment is to treat the HIV itself, and as the immune system improves, the molluscum will resolve.

HIV/AIDS and Herpes

There are two types of herpes: Herpes simplex type 1 (or HSV-1), which occurs most often on or near the mouth and appears as a cold sore, and herpes simplex type 2 (or HSV-2), which occurs most often on or near the sex organs and is sometimes called "genital herpes." The herpes virus is spread by close personal contact, such as kissing or sexual intercourse. Genital herpes is a sexually transmitted disease, or STD.

There is no cure for herpes. Once a person has the virus, it remains in the body. The virus lies latent in the nerve cells until something triggers it to become active again. These herpes "outbreaks," which can include the painful herpes sores, can be controlled with antiviral medication.

Learn more about herpes.

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Shingles Can Be a Painful Link to HIV/AIDS

Shingles, also known as herpes zoster, is an infection caused by the chicken pox virus. This virus remains dormant in the nerve cells of people who have had chicken pox, and can reactivate in the body later on, resulting in illness.

Early symptoms of shingles include tingling feeling, itchiness, numbness, and stabbing pain on the skin. Additional symptoms arise a few days later, and usually include: a band or patch of raised spots on the side of the trunk or face (on one side of the body only), small, fluid-filled blisters, a red rash, and pain lasting for several weeks.

Although shingles, like all other viral diseases, cannot be cured, it usually will go away on its own and may not require any treatment, except to control symptoms. Doctors can prescribe antiviral medications to control the infection, and reduce the severity and duration of the disease.

To combat the pain, doctors may recommend an over-the-counter pain reliever, such as ibuprofen, naproxen, or acetaminophen. A stronger pain reliever, such as codeine or oxycodone, may be prescribed for severe pain and discomfort.

Learn more about shingles.

Psoriasis and HIV/AIDS

Psoriasis is a common skin disorder that produces thick, pink-to-red, itchy patches of skin covered with silvery scales. The rash usually occurs on the scalp, elbows, knees, and lower back and in the same place on both sides of the body. It can also occur in fingernails.

Psoriasis cannot be cured, but treatment greatly reduces signs, even in severe cases. Common treatments include steroid creams, topical vitamin D derivatives, and topical retinoids; these may also be used with ultraviolet light therapy for severe cases. For severe disease, there are a number of effective therapies taken in pill form or by injection.

Learn more about psoriasis.

HIV/AIDS and Seborrheic Dermatitis

Seborrheic dermatitis is an inflammation of the skin around where the sebaceous glands are located (primarily in the head, face, chest, upper back, and groin). When these glands produce too much oil, it causes red and flaking skin.

There is no cure for seborrheic dermatitis. To treat this condition, you can use a shampoo that contains coal tar, zinc pyrithione, or selenium sulfide. Other treatments include topical antifungals such as ketoconazole or topical corticosteroids such as hydrocortisone. In someone with HIV infection, the seborrheic dermatitis will improve as the immune system improves with treatment of HIV.

WebMD Medical Reference Reviewed by David T. Derrer, MD on September 21, 2014

Sources

SOURCES:

AIDS.gov: "HIV Doesn't Cause Cancer, but It Can Increase Your Risk."

AIDS.gov: "Opportunistic Infections and Their Relationship to HIV/AIDS."

MedlinePlus: "Kaposi's Sarcoma."

National Cancer Institute: "General Information About Kaposi Sarcoma."

Johns Hopkins Medicine: "HIV/AIDS and Skin Conditions."

Medscape: "Cutaneous Manifestations of HIV."

 

 

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