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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?

Is the course of syphilis altered in HIV-infected individuals?

Although the course of syphilis in most HIV-infected patients is not different from that in a normal host, it may differ in several ways.

Altered clinical manifestations of syphilis, including the usual painless chancre becoming painful secondary to bacterial infection. Lues maligna, a rare manifestation of secondary syphilis, can occur and consists of pleomorphic skin lesions with pustules, nodules, and ulcers with necrotizing vasculitis.
Altered serologic tests for syphilis, with limited or absent antibody tests for syphilis, including repeatedly negative reagin and treponemal antibody tests. Seronegative secondary syphilis, as well as exaggerated antibody responses, has been reported. Loss of treponemal antibody positivity has also been noted.
There may be concurrent coinfection with another sexually transmitted disease.
There may be a decreased latency period with accelerated development of tertiary syphilis within months to years.
There may be a lack of response to antibiotic therapy with relapses.

Gregory N, Sanchez M, Buchness MR: The spectrum of syphilis in patients with human immunodeficiency virus infection, J Am Acad Dermatol 22:1061–1067, 1990.