HIV-infectious Disease & Cancer

People  with  a  CD4  cell  count  over  200  cells/μL  usually respond  to  a single total body application of  topical  permethrin  (5%)  left on for 8 to 14 hours, and repeated after  1 week. If permethrin is not available, benzyl benzoate 25% emulsion applied for 24-36 hours may be used. The lotion is usually applied once …

Management Read More »

Seborrhoeic dermatitis  Seborrhoeic   dermatitis   is   a   very   common   non-infectious cutaneous presentation of HIV and is observed in 85% of patients with AIDS. (104)  Increased severity and extent of involvement with poorer response to treatment occurs with progressive immunosuppression. Malassezia  may have a role in the pathogenesis of this disease, with higher colonisation in patients with more severe …

Non-infectious disease Read More »

Patients have erythema and yellow-white greasy scaling of the sebaceous areas of the scalp, nasolabial folds, chest, back and intertriginous zone. The eruption is characterised by widespread, scaley, greasy, lesions and may progress to erythroderma. (106) 

Diagnosis is clinical.   Histological and microbiological assessment may assist differentiation from psoriasis, dermatophytosis or atopic dermatitis.  

Initial therapy includes clotrimazole cream, or anti-dandruff shampoos containing ketoconazole or selenium sulfide which can be applied to affected areas and washed off. (107).  Systemic therapy with oral antifungals or isotretinoin may be considered in severe cases.  

The underlying cause of xerosis in HIV is unknown; it may in part be linked to poor nutritional status, polypharmacy, chronic illness and immunosuppression. It is cited as affecting approximately 30% of PLWHIV. (108) Xerosis and ichthyosiform changes of the skin have been considered by several authors as a marker for disease progression as it …

Xerosis Read More »

There are varying degrees of xerosis, but it is generally characterised by diffuse dryness of the skin with hyperpigmented scales and focal crusting.  (109)

Diagnosis is made on clinical assessment alone. Assessments of micronutrient status, such as vitamin A, B3, zinc and copper may be indicated. (110) 

Adequate nutrition is important.  Dry skin care regimens are effective in the management of this condition, with emollients, including those with urea, lactic acid or salicylic acid.  

Psoriasis is a common inflammatory skin condition which affects 2-5% of PLWHIV compared to a prevalence of 1-2% in the general population. (111) Population studies have suggested PLWHIV are at increased risk of developing incident psoriasis, although this has not been demonstrated in the Australian population. (112) Psoriasis is associated with several systemic conditions including psoriatic …

Psoriasis Read More »