Cath Lab Digest

   Huiras and colleagues have noted that while the majority of patients with HIV infection benefit substantially from highly active antiretroviral therapy-induced immune recovery, a subset of patients experience unmasking of new skin disease or paradoxical worsening of existing dermatologic conditions, attributable to immune reconstitution inflammatory syndrome.³⁵ In a review of the current literature regarding the dermatologic manifestations of immune reconstitution inflammatory syndrome, these authors concluded that dermatologic immune reconstitution inflammatory syndrome continues to evolve as the diversity of reported cutaneous immune reconstitution inflammatory syndrome associated disorders expands.

In Conclusion

   The recognition of HIV-related skin changes empowers the podiatric physician to refer a patient to an infectious disease specialist and possibly facilitate diagnosis of HIV infection in the early stages. It is this empowerment of the podiatric physician by sharing current information on the management of cutaneous skin changes of the lower extremity that was the main impetus for the preparation of this review. Thus, an overview pathogenesis of cutaneous skin changes in the HIV patient has been discussed with emphasis on specific lower extremity cutaneous manifestations along with iatrogenic medication induce cutaneous manifestations caused by available antiretroviral agents.

Dr. Smith is in private practice in Ormond Beach, Fla.

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