This document discusses cutaneous manifestations of HIV infection that can be caused directly by HIV or opportunistic infections due to immune deficiency. It classifies the manifestations into viral (such as herpes, molluscum contagiosum, EBV), fungal (candidiasis, cryptococcosis), bacterial (mycobacteria, syphilis, Staphylococcus), and parasitic (scabies, leishmaniasis). Recognizing these cutaneous signs is important for diagnosing HIV infection and providing appropriate antiretroviral therapy.

1. INFECTIOUS CUTANEOUS
MANIFESTATION OF HIV
PRESENTER
ANDREA.R.SALINS

2. OVERVIEW
 Cutaneous manifestation of HIV disease may
be due to HIV infection itself or due to
opportunistic infection secondary to decline
in immuno competence from the disease.
 It is very important to diagnose cutaneous
manifestation so that appropriate
antiretroviral therapy can be given.

3. CLASSIFICATION
 VIRAL
 FUNGAL-------a) superficial
b) deep
 BACTERIAL
 PARASITIC

4. VIRAL
 HERPES SIMPLEX AND HERPES ZOSTER VIRUS
 Recurrent oral and anogenital HSV infection is common
in HIV patients and may lead to chronic ulceration.
 In normal individuals lesions heal within 7-10 days but
takes longer time in HIV patients.
VARICELLA ZOSTER VIRUS-unlike normal vesicles here there may
be bullous,hemorrhagic,necrotic lesions healing with intense scar
formation.
This dermatomal scarring is characteristic feature in HIV patients.

5. HSV INFECTION

6. VZV INFECTION

7.  EPSTEIN BARR VIRUS
 Implicated in pathogenesis of oral hairy leukoplakia
which may develop in HIV patients.
 Filiform white papules located on sides of tongue.
 Confused for lichen planus or oral candidiasis.

8. CYTOMEGALOVIRUS
 DNA virus of herpesviridae family.
 Ulcers in perianal region are most common
presentation of CMV infection in HIV patients.

9.  HUMAN PAPILLOMA VIRUS
 Widespread warts observed in oral
mucosa,face,perianal and female genital tract in
HIV infected individuals.

10.  MOLLUSCUM CONTAGIOSUM
 DNA virus of poxviridae family.
 Small papules with central umblication.
 In HIV patients it may be widespread and atypical.

11. MOLLUSCUM CONTAGIOSUM

12. MOLLUSCUM CONTAGIOSUM

13. FUNGAL
 SUPERFICIAL INFECTIONS
 Recurrent and persistent mucocutaneous
candidiasis is common.
 In adults,Tinea capitis,Tinea versicolor infections
are seen recurrently.

14.  DEEP INFECTIONS
 Rarely cutaneous Cryptococcosis may be seen
which manifest as-cellulitis,papules,ulcers,plaques
etc.
 Pearly translucent papules similar to molluscum
infection.
 Cutaneous histoplasmosis may cause red papules.

15. ORAL CANDIDIASIS

16. BACTERIAL
 MYCOBACTERIAL INFECTION
 M.tuberculosis,M.avium complex(MAC) infection
may present as acneiform papules and indurated
crusted plaques.
 Primary cutaneous infection by MAC is rare.Mostly
due to dissemination.
 Cutaneous manifestation so far reported are:
 -verrucous ulcers -scaling plaques
 -pustular lesion -crusted ulcers
 -draining sinuses -inflammatory nodules

17.  SYPHILIS
 Co infection with syphilis can be seen in HIV
patients.
 Primary syphilis presents with multiple ulcers in HIV
patients.

18.  STAPHYLOCOCCUS AUREUS INFECTION
 Patients with HIV have been found to have
increased cutaneous colonization of S.aureus.
 Presents as-bullous impetigo
 -folliculitis

19.  Bullous impetigo  Folliculitis

20. PARASITIC
 Scabies characterised by widespread
hyperkeratotic,scaly,maculopapular,eruption or
crusted plaques can occur in HIV infected patients.
 Atypical Leishmaniasis have been reported.