Treatment of skin diseases in HIV-infected patients

Skin diseases are common in HIV-infected patients. Although some of the cutaneous manifestations of HIV-infection resemble more severe forms of common skin diseases, as with seborrheic dermatitis and psoriasis, the response to standard treatment is not as expected. Indeed, this may be the clue that leads the clinician to suspect underlying HIV infection. In addition, hitherto undescribed skin diseases have been seen in the HIV-infected population, for many of which treatment has been discovered serendipitously. It is important for both the dermatologist and the patient to recognize that many of the cutaneous manifestations of HIV infection are difficult to treat because of the underlying immunosuppression. It may not be possible to "cure" a skin disease, but the goal in these cases is to make the patient as comfortable as possible by providing symptomatic relief. Often, imagination is required of the practitioner to find the treatment that will make the patient more comfortable. With patience and determination, the dermatologist can help most patients with HIV-related skin disease.