Paediatric HIV-related skin diseases

Mucocutaneous lesions are a frequent manifestation of human immunodeficiency virus (HIV) infection and/or the acquired immunodeficiency syndrome (AIDS) in adult and paediatric patients alike. These include a wide variety of infective disorders, inflammatory dermatoses and adverse drug reactions. Although there is considerable overlap in the spectrum of skin disease in both groups, significant differences exist. Oral candidiasis, which implies marked immune deficiency in adults with AIDS, may occur without severe CD4+ T-cell depletion in children. Infective and inflammatory disorders such as oral hairy leucoplakia, bacillary angiomatosis and HIV-associated eosinophilic pustular folliculitis are exceedingly uncommon in children. Kaposi sarcoma is encountered far less frequently in children, and non-Hodgkin lymphoma in mucocutaneous sites is rarely seen. Stigmata of concomitant nutritional deficiencies are often observed in children. This review gives an overview of this spectrum of disease. The paucity of literature on the immune reconstitution inflammatory syndrome in the paediatric context is emphasized.