Non Infectious Cutaneous Manifestations of HIV - Seborrhoeic Dermatitis, Psoriasis, Ichthyosiform Dermatoses, Pruritic Papular Eruption, Hyperpigmentation, Adverse Cutaneous Drug Reactions, Kaposi Sarcoma, Miscellaneous Dermatoses,

1. -Reshma Ann Mathew

2.  Disorders of epidermal cell kinetics-
Seborrheic dermatitis, Psoriasis, Reiter’s
syndrome, Ichthyosiform dermatoses ( Xerosis )
 Papular and follicular eruption of HIV-
Pruritic Papular eruption
 Pigmentary disorders-
Hyperpigmentation, Vitiligo

3.  Adverse cutaneous drug reactions
 Neoplasms-
Kaposi’s sarcoma, lymphoma, melanoma
 Miscellaneous dermatoses-
Pityriasis rubra pilaris, idiopathic
thrombocytopenic purpura, pityriasis rosea,
photosensitivity

4.  Observed in 85% - It may be the initial
cutaneous manifestation of HIV disease
 Involves hairy region of scalp, face, axillae
and pubic region.
 Histologically- inflammatory changes &
keratinocyte necrosis at dermoepidermal
junction
 Management-Topical steroids and oral
Imidazoles (antifungal agents).

6.  Pre-existing psoriasis may worsen and form
guttate lesions, plaques or pustules or
become erythrodermic.
 Occur on extensor surfaces and scalp
 Management-Standard topical therapy,
systemic retinoids.

8.  Xerosis or Acquired Ichthyosis is frequently
observed in more than 30% patients with HIV
infection.
 It is often accompanied by severe generalized
itching.
 Starts on the lower extremities
 Histologically- hyperkeratosis with a thin
granular layer

10.  PPE is asso. with low CD4 count (<100 cells/pl)
 It is characterized by marked pruritus and a
greater involvement of the extremities than the
trunk or face.
 Clinically, the eruptions are follicular or non-
follicular lesions (papules, pustules and nodules)
 often with secondary change(excoriation, prurigo
nodularis)

12.  Cutaneous hyperpigmentation is frequently
seen in late stage HIV
 It is associated with oral pigmentation and
involvement of palms.

13.  It is high in untreated HIV and increasing
immunodeficiency
 The commom drug reaction patterns seen
are-
1) Toxic epidermis necrolysis(TEN), Steven
Johnson Syndrome(SJS)
2) Genital and Oral ulcers
3) Systemic reactions, including fever,
leukopenia, thrombocytopenia, hepatitis,
and nephritis

15.  It is the most common neoplastic complication
of HIV
 begins as pink macules that enlarge and become
palpable.
 They grow into purplish or brown plaques which
may become hemorrhagic and nodular.
 Common sites are trunk, leg, arm, face and oral
cavity.

18. Pityriasis rubra pilaris-
characterized by reddish orange scaling,
plaques and keratotic follicular papules

19. Idiopathic thrombocytopenic
purpura-
non palpable petechiae

20. Pityriasis rosea-
malaise, fever with typical rash