Page 63 - LECTURE NOTES

d) Xerosis (dryness of the skin) and acquired ichthyosis: 25-30%

Generalized dry skin syndrome is frequently observed in patients with HIV infection.

Xerosis may be the initial clinical manifestation of AIDS, and it is often a cause of
pruritus.

Acquired ichthymosis may begin on the lower extremities and disseminate in

advanced HIV disease. Acquired ichthymosis may be a marker of concomitant
infection with HIV-1 and human lymphotropic virus II in persons who uses intravenous

drugs and who have profound helper T – cell depletion.

e) Herpes zoster- with lower CD4 counts CD4 counts (300-400cell/mm3) it tends to

be mutidermatomal or hemorrhagic, disseminated or even ulcerated or recurrent and
it also can occur outside limited dermatome.

f) Human papilloma virus (HPV) infection

In patients infected with HIV, widespread or recalcitrant warts may be observed on the
oral mucosa, the face, the perianal region, and the female genital tract. The perianal

and cervical lesions may be difficult to treat. Large plantar warts caused by HPV-66

and an epidermodysplasia verruciformis like eruption (numerous plane warts on sun
exposed parts of the body), which is believed to be associated with HPV infection,

have also been reported in patients infected with HIV.

g) Pruritic papular eruption (PPE)

PPE is a common cutaneous manifestation in patients infected with HIV. It manifests

as small, itchy, red or skin-colored papules on the head, the neck, and the upper part

of the trunk. The cause is not known. About 81.25% of patients with PPE have
advanced immunosuppression.

3-Skin conditions with advanced disease - In the later stages of HIV disease,

chronic HSV, MC, and CMV appears. Mycobacterial infections and mucocutaneous
candidiasis occur.

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