Skin conditions are common in people with HIV/AIDS. Many, including Kaposi sarcoma, thrush, and herpes, are caused by germs that take advantage of a weakened immune system. That's why they are called "opportunistic" infections. Others, like photodermatitis, may be linked to inflammation caused by an overactive immune system as it revives during antiretroviral drug therapy or due to the drugs themselves.
Here are some of the more common skin conditions related to HIV/AIDS.
This is a highly contagious viral skin infection that may be passed from person to person through skin-to-skin contact, by sharing linens, or by simply touching the same objects. Molluscum contagiosum causes pink or flesh-colored bumps on the skin. In people with HIV/AIDS, an outbreak of more than 100 bumps can occur.
Although the bumps are generally harmless, they won't go away without treatment if you have AIDS. Your doctor may choose to freeze off the bumps with liquid nitrogen (cryosurgery) or destroy them with a laser or topical ointment. The treatment will generally be repeated every 6 weeks or so until they're gone.
Several types of herpes viruses are common in people with AIDS. Herpes simplex viral infections cause an outbreak of sores around the genital area or the mouth. Herpes zoster viral infection is caused by the same virus that causes chickenpox. It can also result in shingles, an extremely painful blistering rash on one side of the body. Herpes viral infections are often treated with antiviral medications.
This is a type of cancer that starts in the cells that line the lymph or blood vessels. Kaposi sarcoma causes dark lesions on the skin, which may appear as brown, purple, or red patches or nodules. Kaposi sarcoma may also cause the skin to swell. The lesions can affect organs, too, including the lungs, liver, and parts of the digestive tract, where they can cause potentially life-threatening symptoms and breathing problems.
The skin condition typically only occurs when your CD4 lymphocyte (also called T4 cell) count is extremely low, meaning that your immune system is severely weakened. The condition is characteristic of AIDS, and when someone with HIV develops Kaposi sarcoma, the diagnosis changes to AIDS. Highly active antiretroviral drugs have greatly reduced the incidence of Kaposi sarcoma and can help treat it if it develops. This cancer also generally responds to radiation, surgery, and chemotherapy.
Oral hairy leukoplakia
This is a viral infection that affects the mouth. It can cause thick, white lesions on the tongue that look hairy. It is particularly common in people with AIDS who have an extremely weakened immune system. Oral hairy leukoplakia doesn't require specific treatment, but effective treatment of HIVS/AIDS with antiretroviral medications can improve your immune system and help to clear up the infection.
Oral candidiasis, also known as thrush, is a fungal infection that causes a thick white layer to form on the tongue or inner cheeks. Thrush can be managed with antifungal medications, mouth lozenges, and mouth rinses. It is quite common in people with AIDS and can be difficult to treat, because the infection tends to come back. Taking effective HIV medication usually improves this condition.
This is a skin condition in which the skin reacts to exposure to the sun by turning darker in color. It's most common in people of color, but anyone with HIV is susceptible to photodermatitis. If you're taking medications to improve immune strength, you may have this reaction as a side effect. Protecting the skin from the sun is usually the strategy used to reduce photodermatitis.
This skin condition involves outbreaks of itchy, crusted lumps on the skin. The itching can be intense and severe. Prurigo nodularis is most common with extremely weakened immune systems, as well as among people of color with HIV/AIDS. Topical steroid treatment (lotions or creams put right on the skin) and managing HIV/AIDS with antiretroviral drugs are used to treat the condition.
Antiretroviral drugs can help prevent and manage some of these types of skin conditions. Other skin conditions may be triggered by the treatment and require other treatments. Talk with your doctor about the best therapy for your particular skin condition.
More Information About HIV from Johns Hopkins Medicine
HIV and AIDS Timeline
From the bleakest early days of the epidemic, Johns Hopkins has been a leader in understanding, treating and preventing HIV and AIDS. Explore 35 years of progress, here and around the world, including the nation’s first HIV-positive to HIV-positive organ transplants, performed at The Johns Hopkins Hospital in 2016.
View the timeline.