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October 1998

The Changing Spectrum of the Cutaneous Manifestations of HIV Disease

Arch Dermatol. 1998;134(10):1290-1292. doi:10.1001/archderm.134.10.1290

CUTANEOUS MANIFESTATIONS of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) have been the topic of much interest since the syndrome was first described in the early 1980s. In fact, it was Kaposi sarcoma (KS) of the skin in young homosexual men, initially described in part by a dermatologist, that first sparked the interest in AIDS itself.1 As has been emphasized repeatedly in the medical literature and as Spira and colleagues2 remind us in this issue of the ARCHIVES, skin disorders are extremely common in these individuals, and in many patients they may be the earliest sign of HIV disease. Furthermore, several skin infections are classified by the Centers for Disease Control and Prevention as AIDS-defining illnesses, and others may serve as markers of disease progression.3 Given the relative ease of examination of the skin and because most skin diseases are amenable to diagnosis by inspection and biopsy, evaluation of the skin remains an important element of the diagnostic process in HIV-infected patients. In addition, these conditions are often debilitating from the standpoint of function and cosmesis. With the advent of newer, more effective treatments for opportunistic infections, and now for HIV infection itself, it is germane to revisit these conditions and to examine the changing incidence and patterns of presentation.

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