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HIV/AIDS and Skin Conditions

Skin conditions are common in people with HIV/AIDS. Many, such as molluscum contagiosum, are caused by germs that take advantage of a weakened immune system. These may be called opportunistic infections. Others, such as prurigo nodularis, may be linked to inflammation caused by an immune system that works poorly..

Here are some of the more common skin conditions related to HIV/AIDS.

Molluscum contagiosum

This is a highly contagious viral skin infection. It may be passed from person to person through skin-to-skin contact, by sharing linens, or by simply touching the same objects. Molluscum contagiosum causes pink or flesh-colored bumps anywhere on the skin. In people with HIV/AIDS, an outbreak can be mild. Or a person can have 100 or more bumps.

The bumps are often harmless. But they won't go away without treatment if your HIV has worsened to AIDS. Antiretroviral therapy raises your CD4 lymphocyte count (also called T cell count). This may help to improve the lesions. Your healthcare provider may also recommend freezing off the bumps with liquid nitrogen (cryosurgery) or destroying them with a laser or topical ointment. The treatment will often need to be repeated until they're gone. They often return and need to be treated again.

Herpes viruses

Several types of herpes viruses are common in people with AIDS. Herpes simplex virus infections cause an outbreak of sores around the genital area or the mouth. The varicella-zoster virus causes chickenpox. It can come out later in life as shingles. This is sometimes a very painful, blistering rash on one side of the body.

Herpes infections are often treated with antiviral medicines. Nearly all herpes viruses can become "latent." This means that the virus stays in the body even after the infection seems to clear. It can cause a new infection later on. 

Kaposi sarcoma

This is a type of cancer. It starts in the cells that line the lymph or blood vessels. Kaposi sarcoma causes dark lesions on the skin. These may appear as brown, purple, or red patches or nodules. Kaposi sarcoma may also cause the skin to swell. The lesions can affect organs, too, such as the lungs, liver, and parts of the digestive tract. They can cause potentially life-threatening symptoms and breathing problems.

This skin condition often only happens when your T cell count is very low. This means that your immune system is severely weakened. This condition is characteristic of AIDS. When someone with HIV gets Kaposi sarcoma or any other opportunistic infection, they are diagnosed with AIDS. Antiretroviral medicines to treat HIV/AIDS have greatly reduced the incidence of Kaposi sarcoma. They also can help treat Kaposi sarcoma if it develops. This cancer often responds to radiation, surgery, and chemotherapy.

Oral hairy leukoplakia

This is a viral infection that affects the mouth. It can cause thick, white lesions on the tongue that look hairy. It is more common in people with AIDS who have a very weak immune system. Oral hairy leukoplakia doesn't need specific treatment. But taking antiretroviral medicines can improve your immune system and help to clear up the infection.

Thrush

Oral candidiasis is also known as thrush. It is a fungal infection that causes a thick, white or red layer to form on the tongue or inner cheeks. Thrush can be managed with antifungal medicines, mouth lozenges, and mouth rinses. It is quite common in people with HIV/AIDS. It can be hard to treat. The infection tends to come back. Taking effective HIV medicine often improves this condition. 

Prurigo nodularis

This skin condition involves outbreaks of itchy, crusted lumps on the skin. The itching can be intense and severe. Prurigo nodularis is most common in people with very weak immune systems and among people of color with HIV/AIDS. Using topical steroid treatment (lotions or creams put right on the skin) and taking antiretroviral medicines are used to treat the condition.

Antiretroviral medicines can help prevent and manage most of these types of skin conditions. Other skin conditions may be triggered by the treatment and require other treatments. Talk with your healthcare provider about the best therapy for your specific skin condition.

Online Medical Reviewer: Barry Zingman MD
Online Medical Reviewer: L Renee Watson MSN RN
Online Medical Reviewer: Raymond Turley Jr PA-C
Date Last Reviewed: 3/1/2021
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