Skin Problems Problems with the skin, nails and hair can be common in people living with HIV and are estimated to occur in 90% of individuals with symptomatic HIV infection. Additionally, people may have more than one skin related disorder at the same time. Many of these problems also affect people without HIV infection, but can be more severe – or more difficult to control – in people living with HIV. Seborrhoeic Dermatitis: known as dandruff when it affects the scalp - is commonly found on the face (especially around the eyebrows and nasal folds), chest, back, groin and armpits. The affected area is usually red with a yellowish, greasy scale. It can cause itching. Psoriasis occurs as a flaky red rash similar to seborrhoeic dermatitis, but more fixed, with thick scales and a silver tinge. It affects the armpits, groin, elbows, knees and lower back. On the hands and feet, it appears as white spots under the skin (pustular psoriasis) and can affect the joints (psoriatic arthritis). Shingles: Varicella Zoster virus lies dormant in the body after chickenpox and can reactivate, causing “shingles”, especially if the immune system is not working so well. Often the initial symptom is pain followed by red rash of fluid-filled blisters, usually on one side the body. If the rash affects the face it may involve the surface of the eye and impair vision. In some cases the virus can lead to herpes zoster encephalitis, an inflammation of the brain. Molluscum Contagiosum is a viral infection and can be found anywhere, but most commonly on the genital area and buttocks. It is seen in children quite commonly as well – usually on the face. In adults living with HIV the lesions may also affect the face. The lesions appear as raised, fleshcoloured, centrally indented bumps with a pearly centre, and can number from one to hundreds. They can be spread easily by shaving or scratching, and may be quite itchy. Human Papilloma Virus is the virus that causes warts. Some types of the virus can be spread sexually and cause genital warts – These can appear anywhere on the genitals, and round/inside the anus. Xeroderma, more commonly known as dry skin, appears as a flat, slightly scaly, itchy rash that comes and goes. It can occur anywhere on the body, but is mostly found on the front of the lower legs. Folliculitis can appear as red pustules around hair follicles and can be very itchy. It can be seen anywhere but is often found on the trunk (body) or arms. Sometimes this is due to infection in the hair follicles but sometimes it is a disorder associated with an allergic-type reaction. Treatment may include antibiotics and/or antihistamine drugs. Photodermatitis is the eruption of itchy, thick, scaly patches on portions of the skin that are commonly exposed to the sun and it can resemble bad sunburn. These areas may also turn lighter in colour than the rest of the skin. Insect Bites often cause exaggerated responses in people with HIV. Scabies mites cause lesions and itching between the fingers, feet, armpits or genitals. Demodex mites cause an itchy eruption, most commonly on the scalp, face and neck. Drug Reactions. People with HIV are at increased risk of developing allergic reactions to medications. The most common symptom is a widespread itchy rash across the back, chest, arms and legs, and occasionally involving the face and mucous membranes. The rash can be flat, resembling sunburn, or with raised bumps. If you suspect a drug reaction you should consult with your doctor before stopping your medication. As people living with HIV are often taking several medications at the same time you will need advice as to which drug is most likely to be responsible. There are also some specific drugs that have side effects which can affect the skin – see individual drug fact sheets. Nails: Yellow discoloration of the nails is seen in people with PCP. Fungal infections can cause Hair: Thinning of scalp and body hair is common among people with HIV for unknown reasons,
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