Dermatopathological challenges in the human immunodeficiency virus and acquired immunodeficiency syndrome era

The histopathological assessment of cutaneous lesions is critical to the definitive diagnosis of many human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome-associated dermatoses, infections and tumours. Dermatopathological challenges stem mainly from the altered histopathological profile of established cutaneous entities compared with that in the HIV-unaffected population, the emergence of new diseases and the impact of therapeutic modalities on cutaneous lesions. This review focuses on some of these diagnostic dilemmas, with emphasis on the following challenges: (i) infective diagnostic pitfalls; (ii) itchy papular skin lesions; (iii) co-lesional comorbid diseases; (iv) drug-induced disease alterations; and (v) neoplastic and pseudoneoplastic proliferations. The drug-induced alterations include highly active antiretroviral therapy-associated disease modifications.