Superficial Fungal Infections and Deep Fungal Infections
Recurrent and persistent mucocutaneous candidiasis is common in patients with HIV infection. In the United States, recurrent vaginal candidiasis is the most common presentation of HIV infection in women.
In adults, generalized dermatophytosis, or Tinea capitis, which is typically caused by Trichophyton rubrum, may suggest HIV infection. Pityriasis versicolor may be persistent, generalized and recurrent in patients with HIV infection.
Deep fungal infections
Cutaneous Cryptococcus may be observed in patients with HIV infection, but it is rare. Clinical manifestations include cellulitis; papules; plaques; ulcers; or translucent domeshaped papules with central umbilication, resembling MC. Cutaneous histoplasmosis may lead to red papules, cellulites - like eruption, ulcerations, acneiform papules, or molluscum - like lesions in patients infected with HIV.
North American blastomycosis may present as a disseminated maculopapular eruption in HIV disease. Systemic coccidioidomycosis may disseminate to the skin, usually as hemorrhagic papules or nodules.
Cutaneous drug eruptions 10%
Sulfonamides may cause urticaria; erythema multiforme; toxic epidermal necrolysis; and systemic reactions, including fever, leukopenia, thrombocytopenia, hepatitis, and nephritis. Toxic epidermal necrolysis has been reported with antibiotics, fluconazole, clindamycin, phenobarbital, and chlormezanone in patients with HIV.
Drug eruptions have been reported as the most common cause of erythroderma in patients infected with HIV. Photosensitivity has been reported in patients with advanced HIV disease. Photoinduced lichenoid drug reactions may be seen particularly in dark-skinned patients.
Aphthosis :- Severe aphthous stomatitis may be associated with HIV disease. Autoimmunity, atopic disease, and urticaria
Thrombocytopenic purpura, vitiligo, alopecia areata, sicca syndrome, pemphigoid, and other autoimmune blistering diseases have been reported in association with HIV disease. Atopic disease may be reactivated by HIV disease. Atopic eczema may be severe in children infected with HIV. Increased serum IgE levels have been found in these children.'
However, increased IgE levels were not correlated with atopic symptoms. Urticaria may occur primarily or as a drug eruption in HIV disease. Photosensitivity has been reported in patients with advanced HIV disease. Photo induced lichenoid drug reactions may be seen particularly in dark-skinned patients.
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