HIV-assoziierte Psoriasis

Abstract

Between 1982 and 1995, over 700 HIV-infected patients with different skin diseases were registered at the Department of Dermatology, Benjamin Franklin Medical Center, The Free University of Berlin. Thirty-six of them (approximately 5%) were diagnosed as having psoriasis. This is clearly a higher prevalence of psoriasis than in the general population (1-2%). If psoriasis lesions are not clinically seen before diagnosis of HIV infection, the disease will preferentially (approximately 80% of these cases) appear during the late stages of the infection (CD4/CD8 ratio < 0.4). Six of the 36 patients with HIV-related psoriasis (= 16%) were found to have severe disease, showing an exsudative clinical picture. In this paper we report in detail on two representative cases from this group of patients. Histological examination also revealed exsudative changes in HIV-infected patients with clinically moderate psoriasis. Immunohistochemically, HIV-related psoriasis showed a moderately decreased number of infiltrating T-cells, in contrast to psoriatic skin from non-infected patients. A marked difference was the reduced expression of the lymphocyte antigen OPD-4 in HIV-related psoriasis. Routine antipsoriatic treatment modalities in combination with systemic retinoids and phototherapy (SUP/PUVA) were successful in the treatment of severe exsudative psoriasis in HIV patients, but the course of the disease was prolonged and exacerbation was more frequent. HIV-related psoriasis was found not to influence the underlying HIV infection.

HIV-Related Skin Disease in the Era of Antiretroviral Therapy: Recognition and Management

“…There has been debate in the literature on the prevalence of HIV-associated psoriasis (80). The largest study on this subject to date found no association when compared to the prevalence of psoriasis in the general population but other smaller studies have noted an increased rate of psoriasis in HIV patients (81)(82)(83).…”

A Case of Psoriasis in an HIV Positive Male

“…systemic immunosuppression [3]. A study in Berlin found that 36 of 700 HIV+ patients had psoriasis, with 80% of them being in late stages of HIV [4]. Their psoriasis course was severe, prolonged and had more frequent exacerbations.…”

Détection et impact d’une séropositivité VIH chez les patients atteints de psoriasis. Une enquête de pratiques

“…La sévérité du psoriasis est corrélée au degré d'immunodépression : les lésions cutanées augmentent lorsque le taux de CD4 diminue, pouvant ainsi constituer un indice clinique de la progression de l'infection par le VIH (7,8,55,56). A l'inverse le psoriasis s'améliore lorsque l'infection par le VIH est bien contrôlée par les traitements antirétroviraux (5)…”