Dermatological manifestations of HIV: Implications for esthetic and clinical management

Abstract

ABSTRACT HIV/acquired immunodeficiency syndrome has significant systemic implications, with dermatological manifestations often being the earliest and most visible indicators of infection. These skin conditions can severely impact patients’ quality of life and esthetic health. This review explores a broad range of dermatological changes associated with HIV, including HIV-specific dermatoses such as papular pruritic eruption, xerosis, eosinophilic folliculitis, prurigo nodularis, and papular mucinosis. It also covers common dermatoses such as seborrheic dermatitis, psoriasis, pityriasis rubra pilaris, and hidradenitis suppurativa. In addition, the review examines skin infections (fungal, bacterial, and viral), HIV-related malignancies (Kaposi’s sarcoma and cutaneous lymphomas), and antiretroviral therapy (ART)-related skin changes including exanthematous reactions and lipodystrophy. Special attention is given to the management of these conditions, which often involves a combination of topical and systemic treatments along with ART. The phenomenon of immune reconstitution inflammatory syndrome and its dermatological manifestations are also discussed, highlighting the complexities of managing skin reactions as the immune system recovers. Furthermore, the review addresses ectoparasitic infestations and skin complications arising from intravenous drug use, which are prevalent in HIV patients. Effective management of these dermatological issues is crucial not only for improving physical health but also for addressing the profound esthetic concerns that affect patients’ psychological well-being. Early recognition and appropriate treatment strategies can lead to better patient outcomes and enhanced quality of life. Advances in ART and dermatological therapies continue to improve the care provided to HIV patients, ensuring a comprehensive approach that considers both medical and esthetic aspects of their health. This review underscores the importance of a multidisciplinary approach in managing the diverse and complex skin conditions associated with HIV.