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Hiv And Aids Timeline

Cutaneous Manifestations of HIV

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 nations first HIV-positive to HIV-positive organ transplants, performed at The Johns Hopkins Hospital in 2016.

What Causes Kaposi’s Sarcoma

Kaposi’s sarcoma is caused by a virus called the human herpesvirus 8 , also known as the Kaposi’s sarcoma-associated herpesvirus .

The virus is thought to be spread during sex, through blood or saliva, or from a mother to her baby during birth.

HHV-8 is a relatively common virus, and most people who have it will not develop Kaposi’s sarcoma.

The virus only seems to cause cancer in some people with a weakened immune system, and people who have a genetic vulnerability to the virus.

A weakened immune system allows the HHV-8 virus to multiply to high levels in the blood, increasing the chance of it causing Kaposi’s sarcoma.

The virus appears to alter the genetic instructions that control cell growth. It affects the cells that line the inside surface of blood vessels and lymphatic vessels, called endothelial cells.

The endothelial cells reproduce uncontrollably and form lumps of tissue known as tumours.

What Causes Kaposis Sarcoma

Kaposiâs sarcoma is caused by a virus called the human herpesvirus 8 , also known as the Kaposiâs sarcoma-associated herpesvirus .

The virus is thought to be spread during sex, through blood or saliva, or from a mother to her baby during birth.

HHV-8 is a relatively common virus, and most people who have it will not develop Kaposiâs sarcoma.

The virus only seems to cause cancer in some people with a weakened immune system, and people who have a genetic vulnerability to the virus.

A weakened immune system allows the HHV-8 virus to multiply to high levels in the blood, increasing the chance of it causing Kaposiâs sarcoma.

The virus appears to alter the genetic instructions that control cell growth. It affects the cells that line the inside surface of blood vessels and lymphatic vessels, called endothelial cells.

The endothelial cells reproduce uncontrollably and form lumps of tissue known as tumours.

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Hair And Nail Disorders

Diffuse alopecia or alopecia areata may be associated with HIV disease and may be inflammatory and permanent. The apoptotic follicular stem cell population in higher proportion may represent a hair cycle disturbance in patients with diffuse alopecia related to HIV-1 infection.

Beau lines, telogen effluvium, and pallor of the nail beds are the general effects of the chronic illness. Elongation of the eyelashes and softening and straightening of the scalp hair may be observed in HIV disease, and proximal subungual onychomycosis is also usually a sign of HIV disease. The frequency of onychomycosis may be higher in men than in women.

Generalized alopecia can occur in patients with HIV who are treated with indinavir, an antiretroviral protease inhibitor. Zidovudine is associated with longitudinal, transverse, or diffuse melanin pigmentation of the nails however, nail pigmentation has also been observed in patients with HIV who have never taken zidovudine.

Side Effects Of Hiv Drugs

Characteristics Of HIV Rash

Some common HIV medications can also cause rashes, including:

Based on their environment and the strength of their immune system, an individual can have more than one of these conditions at the same time. Treatment might need to address them individually or all at once.

If a rash is present on the skin, consider discussing symptoms with a healthcare provider. Theyâll assess the type of rash, consider current medications, and prescribe a treatment plan to relieve the symptoms.

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Rashes Caused By Another Infection Or Condition

Rashes associated with HIV can develop indirectly as the virus weakens the immune system. HIV destroys the cells of the immune system that are designed to fight infections, so if you are exposed to another virus, you may be more likely to become infected. If youre susceptible to rashes due to other conditions, you may experience more of these rashes because your immune system is already compromised.

  • Insect bites or stings

The severity of your rash may depend on how healthy your immune system is. People with HIV need to monitor their health very closely, so its wise to make an appointment with your medical provider if you notice a rash developing. In addition, try to avoid itching the skin where the rash is since broken skin could increase the risk of infection.

Posted by Dr. Chris

There are many types of skin diseases that can affect a person irrespective of their HIV status. Similarly, HIV-positive patients are prone to various skin diseases that are unrelated to HIV infection. However, there are number of HIV-related skin diseases that have to be considered as these conditions are more likely to arise with the immune deficiency associated with HIV infection.

If I Am Pregnant And Have Hiv Will My Baby Also Have Hiv

Most women with HIV can protect their baby from becoming infected during pregnancy. Proper pre-natal treatment can reduce the risk that an HIV-positive mother will pass the virus to her child to less than 1 percent. The only way these special treatments can be provided is if the health care professionals know the mother is living with HIV. Treatment is most effective when started early in pregnancy. HIV-positive moms should not breastfeed their babies because HIV is sometimes passed this way.

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Herpes Simplex And Herpes Zoster Viruses

Recurrent oral and anogenital HSV infection is common in patients infected with HIV, and it may lead to chronic ulcerations. In pediatric patients, HSV stomatitis is more common than varicella-zoster virus and may become chronic and ulcerative. Patients with VZV may develop chronic ecthymatous VZV .

Acute disseminated HZV infection and the following atypical manifestations have also been described:

  • Hyperkeratotic papules

  • Chronic ulcerations

  • Disseminated ecthymatous lesions

According to Leibovitz et al, chronic VZV infections associated with HIV-1 infection begin as vesicles and progress into necrotic, nonhealing ulcers. Chronic VZV infection may mimic basal cell carcinoma.

When To Get Medical Advice

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See a GP if:

  • you have symptoms that could be caused by Kaposi’s sarcoma
  • you’ve been diagnosed with Kaposi’s sarcoma and your symptoms have become worse
  • you’ve had Kaposi’s sarcoma in the past and it’s returned

If the GP thinks you may have Kaposi’s sarcoma, they’ll refer you for further tests to confirm the diagnosis.

If you have HIV, you can also contact your local HIV clinic if you have any concerns.

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Acute Hiv Infection Rash

A rash is one of the earliest symptoms of HIV. It develops during acute HIV infection, which occurs just after contracting the virus. A rash is just one of the many possible symptoms of acute HIV infection, which include:

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  • Swollen tonsils or mouth ulcers

These symptoms may begin a few days after being exposed to HIV, but they typically become most noticeable about two to four weeks after infection occurs. They can last anywhere from a few days to several weeks or months.

An acute HIV infection rash and other symptoms of this stage of infection can easily be confused for other ailments or conditions, like the flu or a cold. As a result, many people dont realize that they have HIV.

If you experience an unexplained rash and you have potentially been exposed to the virus, get tested for HIV as soon as possible. Be extra cautious about having safe sex since if you do have an acute HIV infection the viral load is very high during this stage, and youre more likely to pass the virus on to your partners. If youve been taking PrEP and find out you have HIV, you need to stop taking it right away to avoid other health complications.

How Does Hiv Rash Look On Black Or Dark Skin

Theres no one-size-fits-all or one-look-fits-all, as it were when it comes to an HIV rash. It can show up in a range of colors, depending on your skins base color. On melanin-rich skin, the raised area may look purple. The small bumps on the raised area may look flesh-colored, white, red, or purple. It may also appear on your hands or feet instead of your trunk and face.

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Other Symptoms To Watch For

Since an HIV rash signals a problem with the bodys immune system, many people will experience other symptoms along with a skin rash. These symptoms may include:

  • Swollen lymph nodes
  • Flu-like symptoms, such as the chills, achy muscles, and a general feeling of illness

If your rash is especially large or causes swelling, you might also experience issues with mobility or getting around.

How Is Hiv Diagnosed


An HIV antibody test, either from a blood sample or an oral sample , can tell whether you have been infected. A negative test result means no HIV antibodies were found. This usually means you are not infected. However, if you engaged in behavior that could spread the virus within three months of having the test, antibodies may not be detectable and you should be re-tested. A positive test result means antibodies to HIV were found. This means you are infected with the virus and can pass HIV to others even if you have no symptoms. You are infected for life. Even if you think you have a low risk for HIV infection, consider getting tested whenever you have a regular medical check-up.

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Hiv/aids And Skin Conditions

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.

Treating The Rash At Home

  • 1Apply medicated cream to the rash. Your doctor may prescribe anti allergy creams or medication to help with any discomfort or itching. You can also buy over-the-counter antihistamine cream to help with these symptoms. Apply the cream as directed on the package.
  • 2Avoid direct sunlight or extreme cold. These are both triggering factors for HIV rashes, and can make your HIV rash worse.XResearch source
  • If you are going to go outside, apply sunscreen to your body to protect your skin or wear long sleeves and pants.
  • Wear a coat and warm clothing when going outside to avoid exposing your skin to extreme cold.
  • 3Take cold water baths and showers. Hot water will irritate your rash. Skip the hot baths or showers and go for a cold water bath or sponge bath to soothe your skin.XResearch source
  • You can use lukewarm water and pat, rather than rub, at your skin in the shower or the bath. Apply an all natural moisturizer to your skin to help it heal, such as creams that contain coconut oil or aloe vera, as soon as you get out of the bath or shower. The top layer of your skin is like a sponge, so applying moisturizer once you have stimulated your pores will trap water inside your skin and prevent dryness.
  • 4Switch to mild soap or herbal body wash. Chemical based soap can irritate your skin and cause dryness and itching. Look for mild soap, such as baby soap, or herbal body wash at your local drugstore.XResearch source
  • Tight clothing can also rub against your skin and worsen the HIV rash.
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    Rashes Caused By Reactions To Medication

    Another possible cause of a rash that develops when someone has HIV is a reaction to a medication. In fact, a rash is one of the most common side effects of antiretroviral medications used to treat HIV.

    Rashes that develop due to HIV medications are usually not serious. Monitor the rash for several days to see if it goes away without treatment. If it does not, you may need to switch to a different type of medication or be tested for other possible causes of rash, such as a bacterial infection.

    While most of the rashes that develop from taking ARV meds are harmless, its very important to be aware of a condition called Stevens-Johnson Syndrome . This is a rare but potentially fatal skin rash that may develop when taking certain HIV medications. The symptoms of SJS include:

    • Fever, headache, and other flu-like symptoms
    • Painful, itchy skin
    • A skin rash consisting of red, blistered spots
    • Peeling skin that develops into painful sores
    • Blisters in and around the mouth, nose, eyes, genitals, or mucous membranes

    If you experience symptoms of SJS, seek immediate medical care by visiting an emergency room or calling 911.

    Of course, other medications besides HIV meds have the potential to cause a reaction like a rash. If you start taking any new medications, be sure to watch for the development of rashes or other unusual symptoms. In addition, you should work closely with your doctor to make sure any medications you take will not interfere with your HIV treatment.

    Treatments Your Physician May Prescribe

    HIV and the Skin Part 1 – Mucocutaneous Markers of Profound Immunosuppression

    Your doctor will base the diagnosis on your symptoms and signs as well as the likelihood that you may be in a high-risk group, such as people who are sexually promiscuous, use illicit intravenous drugs, or engage in unprotected or unsafe sex, especially men who have sex with men.Primary HIV infection occurs before an individual develops sufficient HIV antibodies needed to test positive on a blood test. These antibodies can take 24 months to develop. Therefore, repeated HIV-antibody blood tests over time are recommended when an individual is very likely to be infected.Any person with primary HIV infection should notify sexual partner immediately. In most states, doctors are required by law to report HIV infections to the public health department.A number of drugs have been developed to treat HIV and infections. Although a cure is not possible, people with HIV infection live longer now and enjoy a much better quality of life than those in the early years of HIV awareness. Treatment is tailored for each person to make it as simple, effective, and with as few side effects as possible, and this often involves taking a mixture of medications, carefully overseen by your doctor.

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    What Does An Hiv Rash Look Like

    Usually HIV infection leads to a brief period of symptoms shortly after infection occurs. Not everybody notices these symptoms, and theyre easy to mistake for a cold or the flu. One of the symptoms may be a rash.

    The most common HIV rash occurs shortly after infection. It is an itchy rash that usually appears on the abdomen, face, arms, or legs and features a flat, red area covered in small red bumps.

    Management Of Skin Conditions In Hiv/aids

    Classification of HIV dermatosis

    Skin diseases of HIV-infected persons can be systematically classified by their pathogenesis . Selected skin diseases are discussed in this chapter.


    The drug history, morphology of primary lesion and CD4 count, are important clues to skin diagnoses. In many cases, HIV-associated skin diseases can be easily recognised on clinical grounds, especially in the early HIV disease where clinical atypia is less frequent.

    When diagnostic difficulty is encountered, skin biopsy should be considered for both histologic and microbiological evaluation. As HIV-infected persons frequently have more than one dermatosis, several biopsies may be necessary.


    Skin diseases are rarely life-threatening, but many of them are life-ruining. While the lifespan is prolonged by the use of HAART, many HIV-infected patients are troubled by drug-induced facial lipoatrophy. Not only can there be cosmetic disfigurement, the intense pruritus due to eosinophilic folliculitis may severely impair the patients’ quality-of-life. Therefore, management of these apparently minor conditions should not be overlooked.

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    When Is Hiv Contagious

    During the clinical latency stage, a person with HIV experiences fewer symptoms. However, they can still transmit the virus to others.

    According to the CDC, a person with an undetectable viral load cannot transmit HIV to another individual. This is because HIV treatment suppresses the virus, leaving a low presence of the virus in the blood.

    When HIV is not detectable in a test, it is not transmissible.

    Recognizing The Symptoms Of An Hiv Rash

    Scrofuloderma in an HIV
  • 1Check for a rash that is red, slightly raised, and very itchy.XResearch sourceDale Prokupek, MD. Internist. Personal interview. 16 April 2020. HIV rash usually causes blotches and spots on the skin, red for people with fair skin and dark purplish for people with dark skin.
  • The severity of the rash varies from patient to patient. Some get a very severe rash that covers a large area, while others only have a minor rash.
  • If the HIV rash is the result of antiviral medications, the rash will appear as raised reddish lesions that cover your whole body. These rashes are called “drug eruptions”.
  • 2Note if the rash appears on your shoulders, chest, face, upper body, and hands. This is usually where the HIV rash shows up on your body. However, the rash tends to disappear by itself within a few weeks. Some people mistake it for an allergic reaction or eczema.
  • HIV rash is not transmittable, so there is no risk of spreading HIV via this rash.
  • 3Pay attention to other symptoms that may occur when you have HIV rash. These include:XResearch source
  • Nausea and vomiting
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