HIV rash-Pictures, Location, Causes, Symptoms & Treatment

HIV rash is very common among people infected with HIV virus. HIV rash can be caused by HIV virus and also by many other types of infections that occur in a person infected with HIV virus. Let us explore all the causes, symptoms and treatment options of HIV rash.

What is HIV?

HIV virus attacks the immune system and lowers our immunity levels. It affects the CD4 T cells or lymphocytes, macrophages, and dendritic cells. Due to this HIV infection, our cell mediated immunity is damaged. As a result of this, our body cannot fight against life threatening infections and cancers.

These infections and cancers attack the HIV infected person and eventually can even kill the person. A person with HIV infection does not die because of HIV virus. He dies because of the lowered immunity levels which facilitate attack by various deadly infections and cancers. Without getting any treatment, a person infected with HIV infection survives for only 9 to 10 years from the time of contracting the infection.

HIV virus or Human immunodeficiency virus infection ultimately leads to AIDS or Acquired immunodeficiency syndrome when the CD4 T cell count falls below 200 cells. AIDS is the severest form of HIV infection with a highly weakened immune system.

HIV rash causes:

HIV rash
HIV rash
Image source: medicalnewstoday.com

HIV infection itself can cause a rash. But, as we already discussed many other opportunistic infections can attack a person with HIV infection. These infections can also lead to the development of a rash. So, it’s important to know about various causes of rash in HIV infected person. We shall discuss Early HIV rash and also about other diseases which can cause a rash in the HIV affected person.

Early HIV rash:

Early HIV rash is one of the most common symptoms of Acute HIV infection, that is when you are infected with HIV infection for the first time in life. Acute HIV infection leads to seroconversion illness. During the seroconversion illness or phase, the infected person develops flu like symptoms and Early HIV rash. It is very easy to get confused about these symptoms with common cold or flu.

More than 80% of people with Acute HIV infection develop Early HIV rash. This seroconversion illness along with the Early HIV rash occurs after 2 to 4 weeks after getting infected with the HIV virus. This rash persists for about 2 to 3 weeks after its appearance. Then there is a window period of several weeks during which the body tries to develop antibodies against the infection.

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After the window period, the person infected with HIV can remain asymptomatic for many years. In some people only mild symptoms occur and HIV might not be suspected based on that. After several years of developing this seroconversion illness and Early HIV rash, the more serious symptoms of AIDS develop.

If we delay the treatment until the development of these symptoms after several years, treatment might not be effective. So, we need to identify HIV infection in the seroconversion phase itself and perform laboratory tests to diagnose the infection.

But, there are many other causes of rash in the body apart from HIV infection. In fact, all other causes are more common and probable than HIV. So, every person with a rash on their body need not worry about HIV. You need to keep yourself informed about the appearance of the rash of HIV by looking at pictures of HIV rash and knowing about other symptoms of acute HIV infection.

Also, if you have participated in any unprotected sexual intercourse or if you have multiple sexual partners or if you are an injection drug abuser, or you have received a blood transfusion or if you a healthcare worker who got a needlestick injury, then you need to be extra cautious when you develop rash and flu like symptoms. You need to visit your physician to get the appropriate tests done for timely diagnosis.

Molluscum contagiosum:

Molluscum contagiosum is another cause of HIV skin rash. It is a skin disorder caused by a virus called pox virus. It can affect people of all age groups ranging from kids to adults. It can affect both men and women.

Shingles or Herpes Zoster:

It is a rash on the skin which is caused by a virus called varicella zoster virus. The same varicella zoster virus causes chickenpox as well. Chickenpox is a very common skin rash which is known to everyone. When a person develops chickenpox in the childhood, this varicella zoster virus goes and stays dormant in the dorsal root ganglion of the spinal cord.

Later on in life, when the immunity of the person is weakened this varicella zoster virus gets reactivated and causes shingles or Herpes zoster.

Herpes simplex:

It is a skin rash caused by Herpes Simplex Viruses. There are two types of Herpes simplex rashes. They are caused by HSV 1 virus and HSV 2 virus. Herpes simplex rash can occur around the mouth or on genitals.

Kaposi sarcoma:

It is a skin cancer that can occur in patients having HIV infection. It appears like spots on the skin which are dark in color. These spots caused by Kaposi sarcoma can be red, brown or purple in color.

Drugs used for the treatment of HIV:

HIV infection or AIDS is treated with several antiviral drugs. Many of these antiviral agents used to treat HIV infection can lead to the development of a rash on the body like a side effect. Some examples of anti-HIV drugs or medications which can cause a rash as a side effect include Abacavir, Raltegravir, Dolutegravir, Nevirapine, etc. This HIV skin rash caused by drugs can persist for several days or weeks.

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Eosinophilic folliculitis:

It is a skin rash caused by inflammation of the hair follicles over the skin. It is associated with increased number of eosinophils within the hair follicles and also around it. They can be found when the skin containing these hair follicles is biopsied. It occurs when the counts of T helper cells is less than 200 cells.

Other disorders which can cause HIV skin rash:
  • Bullous Impetigo
  • Ecthyma
  • Bacillary Angiomatosis caused by Bartonella
  • Skin rash caused by Pseudomonas aeruginosa
  • Warts caused by Human Papilloma Virus (HPV)
  • Cutaneous infection caused by Mycobacterium
  • Fungal infections of skin
  • Rash caused by Syphilis
  • Ichthyosis
  • Seborrheic dermatitis
  • Reiter’s syndrome
  • Atopic Dermatitis
  • Scabies
  • Insect bite reactions
  • Porphyria cutaneous tarda
  • Pruritic papular eruptions
  • Photosensitivity reactions

HIV rash location:

We have seen various causes of HIV skin rash. Let us look at the locations of the body where this rash can occur.

Early HIV rash location:

This rash appears mostly over the upper body, which includes chest and abdomen. It can also occur over the face, arms, and legs. Any part of the body can be affected by HIV rash.

Herpes simplex rash:

As we already discussed, there are 2 types of Herpes simplex, and they are the HSV 1 and HSV 2. The rash caused by HSV 1 is mainly located around the mouth and lips. It is called oral Herpes. The rash caused by HSV 2 is mainly located over the genitals. It is called the genital Herpes.

Herpes Zoster rash or Shingles:

This rash is located only over a particular dermatome. A dermatome is the area of skin supplied by a particular nerve. It doesn’t occur all over the body in a generalized manner. It occurs only on one side of the body.

Molluscum contagiosum rash:

It mainly occurs over the trunk (chest and abdomen). It can occur over any part of your body. But, the appearance of this rash over hands and soles of the foot is less common.

Medication induced rash:

The rash caused by antiretroviral drugs can occur anywhere over the body. But, it’s less common over the face. But, if the rash is also appearing over the face, like around the eyes, mouth, nose, tongue, it indicates something serious. You will have to consult your physician immediately.

HIV rash symptoms:

Early HIV rash:

This rash appears with different colors on the skin of people with different skin colors. For example, Early HIV rash over the light skinned people is red and the color of the rash over dark skinned people is purple. This rash can last for about 2 to 3 weeks.

Along with the rash, people with Acute HIV infection also have other symptoms like fever, sore throat, cold, fatigue or tiredness, enlargement or swelling of lymph nodes, myalgia or muscle pain, headache, etc.

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Molluscum contagiosum:

This disorder leads to the formation of small bumps which are skin colored or pearly white in color. They have central umbilication or depression. All the bumps appear similar. They are larger in size in people affected with HIV than in normal people. They are painless. They even heal without scarring. But, they take about 6 months to 1 year to heal spontaneously.

Herpes Zoster rash:

It can appear like groups of blisters or vesicles on one side of the body, either on the chest, or abdomen, or face, etc. This rash is extremely painful. It can be painful even after the rash has healed, and it is called post herpetic neuralgia. Pain is also present before the appearance of the rash, and it is called preherpetic neuralgia.

Herpes simplex rash:

The rash caused by Herpes simplex is also vesicular or presence of blisters on the skin. These blisters are filled with fluid. Eventually, these blisters can break open and form an ulcer or scab. They are very painful. They appear either on or around the mouth or over genitals. But, sometimes it can also appear over the finger or as Herpes on the leg, etc.

Drug induced rash:

Most rashes in HIV caused by drugs occur during the second week after starting the antiretroviral drugs or anti-HIV drugs. This rash is mostly maculopapular or morbilliform rash. This rash appears similar to the rash of measles.

But, sometimes adverse drug reactions can occur leading to life threatening skin disorders like Toxic epidermal necrolysis and Steven Johnson syndrome. So, watch out for symptoms like blister like rash around mouth, eyes, genitals, peeling of skin, breathing difficulty, fever, etc. If such symptoms occur along with the rash while you are taking anti-HIV drugs, you need to consult your doctor right away.

HIV rash treatment:

The treatment of HIV rash mainly depends on the exact condition you are suffering from. This is because a multitude of causes can lead to HIV rash. You need to visit your doctor or dermatologist, who can prescribe you the exact treatment based on the condition you are suffering from. But, you can follow some general measures which are applicable to all skin rashes like:

  • Wearing clothes which are loose and comfortable. Avoid wearing tight fitting clothes.
  • Avoid roaming around in the hot sun or excessive sun exposure.
  • Avoid taking bath with very hot water.
  • Don’t use any chemical based cosmetics or moisturizers, etc, as they can further irritate the skin.
  • Use the drugs prescribed by your doctor at proper timings.

HIV rash pictures:

Early HIV rash
Early HIV rash
Image source: healthool.com
Molluscum contagiosum
Molluscum contagiosum
Image source: regionalderm.com
Herpes zoster
Herpes zoster
Image source: healthhype.com
Herpes simplex
Herpes simplex
Image source: aad.org
References:
  1. http://www.medscape.com/viewarticle/467763
  2. http://www.medscape.com/viewarticle/719121
  3. http://emedicine.medscape.com/article/1133746-overview
  4. http://hivinsite.ucsf.edu/InSite?page=kb-04-01-01
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4447481/

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