HIV/AIDS Kaposi sarcoma: the Indian perspective

Area of Science:

• Dermatology
• Infectious Diseases
• Immunology

Background:

• A 58-year-old male with diagnosed human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) presented with a persistent, itchy, violaceous skin eruption on his left leg.
• The eruption had been progressing insidiously for two years, despite the patient's adherence to highly active antiretroviral therapy (HAART).

Observation:

• The patient also developed pulmonary tuberculosis, requiring a 9-month course of antitubercular therapy.
• Despite treatment for both HIV/AIDS and tuberculosis, the dermatological lesions continued to progress, accompanied by significant weight loss and appetite loss.

Findings:

• The patient's HIV viral load was suppressed to < 20 copies/mL, indicating effective viral control.
• The persistent and progressive nature of the skin eruption, despite optimal medical management for HIV/AIDS and tuberculosis, suggests an atypical presentation or an underlying condition beyond standard opportunistic infections.

Implications:

• This case underscores the need for a comprehensive diagnostic approach in HIV/AIDS patients presenting with unusual or refractory dermatological conditions.
• Further investigation may be warranted to identify the specific etiology of the skin eruption, potentially involving less common opportunistic infections or immune reconstitution inflammatory syndrome (IRIS).
• Clinicians should remain vigilant for atypical presentations in immunocompromised patients, even when viral load is suppressed.