Noninfectious inflammatory skin diseases in HIV-infected individuals

Noninfectious inflammatory skin diseases are often a persistent problem for patients with infection with the human immunodeficiency virus (HIV), and they present both diagnostic and therapeutic challenges for the dermatologist. Well-defined diseases such as granuloma annulare, reactions to insect bites, and leukocytoclastic vasculitis may be more severe in these individuals and may be refractory to therapy. More poorly defined conditions with psoriasiform and papular morphologies have also been described. A number of skin conditions, including pityriasis rubra pilaris, cutaneous T-cell lymphoma, and erythema elevatum diutinum, have recently been observed in the HIV-infected host. Because the dermatologist plays an important role in diagnosis and management of patients with HIV infection, it is important that he or she be well versed in the clinical manifestations and natural history of these conditions.