Psoriasis indicates HIV infection

Doctors were warned to be more watchful of suspicious manifestation of skin diseases after a case study published at the Singapore Medical Journal (SMJ) last month reported a 29-year old, unnamed man from Catanduanes, initially diagnosed with of psoriasis, was found to have developed the skin ailment due to HIV infection.

Psoriasis is a long-lasting, non-contagious skin disease characterized by red, itchy plaques and patches on the skin due to abnormal immune response of the body. Specific cause is unknown, but various factors such as lifestyle, drug allergy, and genetic susceptibility are thought to trigger the development of the disease. There is no known cure for psoriasis but treatments are available in managing its symptoms and spread.

In the case study, clinicians at the University of the Philippines Manila – Philippine General Hospital (UPM-PGH) reported that the attending physicians initially suspected drug allergy as the cause of the patient’s psoriasis. As such, the suspected drug was discontinued and the patient was prescribed with anti-inflammatory medication to manage the symptoms. Despite the treatment, the patient did not show signs of recovery, prompting them to counsel the patient to undergo testing for HIV infection. The patient died of respiratory failure a few weeks after refusing HIV testing. Autopsy report confirmed the patient to be HIV positive.

90% of patients with HIV infection are affected with various kinds of skin diseases, including psoriasis. While there is no difference in prevalence among patients with HIV infection and those who are HIV free, psoriasis among people with HIV were likely to be more severe.

The researchers explained that psoriasis and other skin ailments are good marker for the progression of HIV infection. Physicians’ aptitude and alertness to recognize suspicious skin diseases are important in early diagnosis of HIV infection. They said, “Clinicians should be attuned to the skin signs heralding HIV or AIDS, in order to facilitate early diagnosis and treatment.”

Reference: Ostraceous and inverse psoriasis with psoriatic arthritis as the presenting features of advanced HIV infection. Singapore Medical Journal 55, e60-e63. Retrieved May 13, 2014, from http://sma.org.sg/UploadedImg/files/SMJ/5504/5504cr4.pdf

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