World AIDS Day 2023: How AIDS affects your skin; measures to prevent infections

“Acquired Immunodeficiency Syndrome (AIDS) is a condition caused by the Human Immunodeficiency Virus (HIV), which attacks the immune system, leading to a weakened defense against infections. The skin, being the body’s largest organ, often reflects the overall health of the immune system. Individuals with AIDS are particularly susceptible to various skin conditions due to their compromised immunity,” says Dr Rinky Kapoor, Consultant Dermatologist, Cosmetic Dermatologist & Dermato-Surgeon, The Esthetic Clinics.

“Seborrhoeic dermatitis is one of the earliest and most common manifestation in which the patient presents with itching and widespread and excessive greasy flakes over scalp (dandruff), face and skin folds like underarms and groin. They can also be at risk of Herpes zoster (shingles), which presents with grouped painful blisters associated with pus, erosions and crusting localised on one side of the body. This is caused by reactivation of the chicken pox virus due to immunosuppression, which lies dormant in nerves of the skin after infection during childhood. In AIDS, shingles is more widespread, crossing over to the other side involving large areas and lasting longer than usual,” says Dr Aayush Gupta, Associate Professor and Consultant Dermatologist.

Dr Rinky Kapoor shares common skin infections that can affect HIV/AIDS patients:

1. Candidiasis

One common dermatological manifestation is fungal infections, such as candidiasis. Candida, a yeast-like fungus, can cause infections in moist areas like the mouth, throat, and genital region. In individuals with AIDS, these infections can be persistent and challenging to treat.

2. Herpes simplex virus

Viral infections are also prevalent, with herpes simplex virus (HSV) causing oral and genital herpes. Lesions may be more severe and recurrent in individuals with AIDS, requiring antiviral medications for management.

3. Bacterial infections

Bacterial infections, including staphylococcal and streptococcal infections, can lead to cellulitis or boils. These skin conditions may be more aggressive in individuals with compromised immune systems, necessitating prompt medical attention.

“Due to reduced immunity, bacterial skin infections also become more common and recurrent leading to painful wounds with pus discharge, including tuberculosis of the skin which presents with non-healing deep wounds and ulcers,” says Dr Gupta.

4. Seborrheic dermatitis

Furthermore, seborrheic dermatitis, characterized by red, itchy, and flaky skin, is common in AIDS patients. It often affects the scalp, face, and chest.

5. Kaposi’s sarcoma

Kaposi’s sarcoma, a cancer linked to human herpesvirus-8 (HHV-8), presents as skin lesions that are typically purplish in colour. This condition is more prevalent in individuals with AIDS, emphasizing the intricate relationship between immunosuppression and certain malignancies.

6. Scabies

Scabies is another common manifestation caused by infestation with a mite, presenting as small bumps and scratches over finger webs, underarms, abdomen, groin, thighs genitals and buttocks. Itching which is intense at night is typical.

“Scabies is another common manifestation caused by infestation with a mite, presenting as small bumps and scratches over finger webs, underarms, abdomen, groin, thighs genitals and buttocks. Itching which is intense at night is typical,” says Dr Gupta.

“Other viral infections that are common in AIDS include Molluscum contagiosum which presents as multiple painless skin coloured dome shaped bumps and viral warts which present as multiple painless, finger like rough projections over the body. HIV is also associated with inflammatory conditions causing itchy red bumps over the limb and trunk, the cause of which is poorly understood and thought to be due to some kind of hypersensitivity reaction. All these manifestations can serve as clues for early diagnosis facilitating early intervention and better disease outcome,” says Dr Gupta.

Prevention tips

“Regular skin checks are crucial for individuals with AIDS to detect any abnormalities early. Seeking medical advice promptly allows for timely intervention, preventing the progression of these conditions. Dermatological care, coupled with antiretroviral therapy to manage HIV, plays a vital role in enhancing the quality of life for individuals affected by AIDS,” concludes Dr Kapoor.