Herpes Simplex

Herpes simplex mostly appears around the mouth and nose and is often called “cold sores”. They usually heal within seven to fourteen days, however more severe outbreaks may occur, lasting for longer periods in HIV patients. It is possible for the herpes infection to spread into the body causing symptoms of high fever, mental confusion, headaches and weakness.

Herpes can also appear as a skin rash due to the reactivation of the dormant chickenpox virus, herpes zoster or shingles. This usually appears in a band-like pattern to a specific area on one side of the body. Severe pain is due to the inflammation of the infected nerves in the area of the rash. This can last for several weeks and spread to other parts of the body with blisters like chickenpox. Topical lotions and anti-viral medications may be helpful with the blisters.

Molluscum Contagiosum

Molluscum Contagiosum are common skin lesions in children. They appear as smooth waxy skin coloured bumps that may continue to develop in different places. They can vary in size from that of a pin to the size of a large pea. The lesions have a central core filled with white cheesy like material and are not painful or itchy. Treatment involves freezing or removing the centre of the lesion.

Warts

Warts are common, benign, painless growths caused by the papilloma virus and occur on the skin, usually hands, feet or face. Warts can also be seen on genital and anal regions. The warts in HIV infected people are usually larger, more numerous and more widespread and can be particularly resistant to standard treatments.

Oral “Hairy” Leukoplakia

This is an unusual condition which most often occurs on the tongue seen as a small light fuzzy patch due to the Epstein-Barr virus. However, it is rarely treated as it is asymptomatic.

Candidiasis ‘Thrush’

This is a yeast infection found commonly in the mouth, vagina, skin folds under arms, buttocks and groin. Unfortunately it repeatedly and frequently occurs in many HIV patients. In the mouth it appears as white, curd like patches.  It can cause soreness of the mouth or throat, provide swallowing difficulties and loss of taste. Furthermore, it can sometimes spread into the oesophagus causing burning sensations when swallowing. In other parts of the body, the yeast infection appears as a severe itchy red rash involving the groin, genitals and buttock and treatment is in the form of creams and tablets.

Tinea

Tinea is another fungal infection occurring in the scalp, hands, feet and nails. Treatment includes topical or oral medications and is more common in people with HIV.

Tinea is a bacterial skin infection causing the development of multiple clusters of small soft fluid filled blisters which break easily oozing a yellowish liquid. When the blisters break a large shallow ulcer remains with a yellowish crust. Additionally, it is important that careful observations of these skin lesions are required as there is a possibility that the bacterial infection will spread into the bloodstream.

Skin cancers

Skin cancer lesions caused by the herpes virus do not hurt or itch and can appear anywhere in the body or mouth. These vary from pink, dark red, purple or brown and are often mistaken for insect bites, birth marks or bruises. In addition, these range from the size of a pin to that of a large coin and continue to develop into thickened bumps or large tumour growths. More than one lesion may also be present. Lesions on the face or exposed areas can be removed surgically, treated with injections or X-ray therapy.

Lymphomas, producing skin bumps, melanoma or BCC’s are more common in HIV patients. This condition uses standard skin cancer treatments for HIV patients.

Seborrhoeic Dermatitis

This is a flaky red inflammatory condition of the skin affecting the face. Additionally, it can also occur on the scalp as “dandruff” and on the chest and inner groin. This condition will often require more vigorous treatment in HIV patients, with various creams and ointments required.

Psoriasis

HIV patients who have had a previous history of psoriasis can experience a worse condition than usual and the skin condition is often more resistant to treatment.

Hives, Papular Urticaria and ‘Itchy Red Bump Disease

Hives is a widespread itching skin condition which manifests as tiny red bumps the size of a small pea. However, larger patches of hives may occur and these itchy lesions are recurrent, requiring large doses of antihistamines or topical steroid creams.

Folliculitis

Folliculitis occurs around inflamed hair follicles on the chest, back, face, scalp, legs and buttocks. It can also look like an acne eruption and be quite itchy as well as associated with hives. Scratching can lead to skin infections. Treatment is a combination of tablets and topically applied lotions and may respond to ultraviolet light.

Facial Lipoatrophy

This is the redistribution of body fat, also known as lipodystrophy, that occurs in people living with HIV. Lipodystrophy is a characteristic disorder of adipose (fatty) tissue. This is due to both the infection itself along with its antiviral treatment. Its main features are fat loss affecting the face, limbs and buttocks, accompanied by central fat accumulation in the abdomen and breasts and over the dorsocervical spine (the ‘buffalo hump’). Facial lipoatrophy is the most visible component of this disorder. For further information on Lipoatrophy treatment click here

Treatment at The Skin Hospital

At The Skin Hospital our Speciality Clinics are run by dermatologists who have sub-specialised in a chosen condition bringing deep knowledge and specific expertise. The Skin Hospital runs a speciality clinic dedicated to the treatment of HIV skin conditions at Darlinghurst, run by Dr Margot Whitfeld.

If you would like to find out more about this speciality clinic please contact us.