HIV-Associated Psoriasis

Actas Dermosifiliogr (Engl Ed). 2018 May;109(4):303-311. doi: 10.1016/j.ad.2017.09.014. Epub 2018 Feb 1.
[Article in English, Spanish]

Abstract

Human immunodeficiency virus (HIV) prevalence is increasing worldwide as people on antiretroviral therapy are living longer. These patients are often susceptible to debilitating inflammatory disorders that are frequently refractory to standard treatment. Psoriasis is a systemic inflammatory disorder, associated with both physical and psychological burden, and can be the presenting feature of HIV infection. In this population, psoriasis tends to be more severe, to have atypical presentations and higher failure rates with the usual prescribed treatments. Management of moderate and severe HIV-associated psoriasis is challenging. Systemic conventional and biologic agents may be considered, but patients should be carefully followed up for potential adverse events, like opportunist infections, and regular monitoring of CD4 counts and HIV viral loads.

Keywords: Biological therapies; Conventional systemic therapies; Fototerapia; HIV; Immunosuppression; Inmunodepresión; Phototherapy; Psoriasis; Terapias biológicas; Terapias sistémicas convencionales; Topical therapy; Tratamiento tópico; VIH.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Biological Therapy
  • Contraindications, Drug
  • Diagnosis, Differential
  • Disease Management
  • HIV Infections / complications*
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Phototherapy
  • Prevalence
  • Pseudolymphoma / diagnosis
  • Psoriasis / complications*
  • Psoriasis / epidemiology
  • Psoriasis / immunology
  • Psoriasis / therapy
  • Scabies / diagnosis
  • Syphilis / diagnosis
  • Syphilis, Cutaneous / diagnosis
  • Thalidomide / analogs & derivatives
  • Thalidomide / therapeutic use
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

  • Adrenal Cortex Hormones
  • Immunosuppressive Agents
  • Tumor Necrosis Factor-alpha
  • Thalidomide
  • apremilast

Supplementary concepts

  • Syphilis, secondary