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The relationship between HIV and atopic dermatitis

When the body’s immune system is weakened by HIV, it can lead to skin conditions that cause rashes, sores, and lesions. Skin conditions can be among the earliest signs of HIV and can be present during its primary stage. They may also indicate disease progression, as cancers and infections take advantage of immune dysfunction in later stages of the disease. About 90 percent of people with HIV will develop a skin condition during the course of their disease. HIV and atopic dermatitis are related. HIV can cause atopic dermatitis.

Atopic dermatitis (eczema) is a condition that makes your skin red and itchy. It’s common in children but can occur at any age. Atopic dermatitis is long lasting (chronic) and tends to flare periodically. It may be accompanied by asthma or hay fever.  Dermatologic problems affect >90% of patients with HIV infection at some point during their disease. The presence of certain skin conditions in undiagnosed patients, such as extensive herpes zoster infection and seborrheic dermatitis, may serve as indicators of HIV and can facilitate early diagnosis when properly recognized.

Patients with HIV infection exhibit a wide range of skin pathology, including bacterial, fungal, and viral infections, skin tumors, inflammatory and eczematous eruptions, and drug rashes. HIV-infected adults commonly develop a condition that strongly resembles atopic dermatitis and is sometimes called “atopic-like dermatitis”; moreover, atopic dermatitis and other atopic disorders have been described as common manifestations of pediatric HIV infection.

A variety of inflammatory skin conditions have been described in human immunodeficiency virus (HIV)-infected patients since the advent of the disease

Xerosis is seen in approximately 30% of HIV-infected patients and has been attributed to impaired skin barrier function. Excessive levels of carotenoids, especially lycopene, and decrease in lipids in the dermis have been found in these patients. Poor nutritional status, chronic illness, and malabsorption are other implicated factors. Psoriasis is a chronic papulosquamous skin disease which can worsen or appear for the first time (often very severely) in HIV infection. Reactive arthritis (ReA) was first described in association with HIV in 1987. It is a triad of arthritis, conjunctivitis, and urethritis.

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