Pathogenesis, Progression, and Clinical Characteristics of Common HIV-related Skin and Oral Lesions

Introduction

HIV infection can result in various dermatological and oral lesions due to its impact on the immune system. These manifestations often serve as important diagnostic markers and contribute significantly to morbidity among patients.

Pathogenesis

The progression of HIV-related skin and oral lesions is primarily associated with the depletion of CD4+ T cells, leading to opportunistic infections and neoplastic conditions. The compromised immune response allows pathogens such as fungi, viruses, and bacteria to proliferate unchecked.

Common HIV-related Skin Lesions

• Kaposi’s Sarcoma: A vascular tumor linked to Human Herpesvirus 8 (HHV-8), presenting as purple or reddish patches on the skin.
• Seborrheic Dermatitis: Chronic inflammatory skin condition common in HIV patients, characterized by scaly patches in sebaceous areas.
• Molluscum Contagiosum: Caused by the poxvirus, appearing as small pearly lesions on the skin.
• Herpes Zoster: Reactivation of varicella-zoster virus resulting in painful vesicular eruptions along a dermatome.

Common HIV-related Oral Lesions

• Oral Candidiasis: Overgrowth of Candida species leading to white plaques in the oral mucosa.
• Oral Hairy Leukoplakia: Caused by Epstein-Barr virus, appearing as white corrugated lesions on the lateral tongue.
• Necrotizing Ulcerative Gingivitis: Severe gum infection characterized by pain, bleeding, and necrosis.
• Kaposi’s Sarcoma: Also affecting the oral cavity, particularly the hard palate.

Histopathological Changes

Histopathological analysis of these lesions reveals distinct cellular abnormalities. Kaposi’s sarcoma, for example, exhibits spindle cell proliferation, while oral candidiasis demonstrates fungal hyphae invasion into epithelial layers.

Conclusion

Recognizing and managing HIV-related skin and oral lesions is crucial for improving patient quality of life. Early detection and appropriate treatment strategies, including antiretroviral therapy, can mitigate the severity of these conditions.