Psoriasis is a chronic autoimmune condition characterized by increased skin cell proliferation that causes scaly plaques on the skin.
Studies have shown that HIV is linked to a higher likelihood of developing psoriasis and more severe symptoms. In fact, people living with HIV have up to an 80% increased risk of developing psoriasis.
Why are people with HIV at risk of developing psoriasis?
- Overactive immune system. HIV attacks the immune system and destroys cells that are responsible for fighting disease and infection. Psoriasis, however, is caused by an overly active immune system. Psoriasis destroys invading pathogens and healthy cells, including skin cells. Getting the immune system boosted to fight HIV could make a person more susceptible to developing psoriasis.
- Fewer cells are capable of battling illness. Individuals infected with HIV often have reduced amounts of disease-fighting lymphocytes, such as T cells. Because of this, they could be more susceptible to the inflammation that can cause psoriasis and make the condition more severe.
- Unintended consequence of treatment. Immune reconstitution inflammatory syndrome could be a side effect of HIV treatment (also called antiretroviral therapy). HIV may get better with treatment, but at the same time, a person may develop additional illnesses, such as psoriasis.
What are symptoms of psoriasis?
Symptoms of psoriasis associated with HIV are the same as typical psoriasis: raised, irritated, scaly patches of skin that may be covered with silvery scales. In people with lighter skin, the patches may be red, whereas they may be purple, gray, or dark brown in people with darker skin.
People with HIV are more likely to develop psoriasis in the following areas:
How is psoriasis treated in people with HIV?
There are several treatment options for psoriasis in people with HIV, including oral medications, topical steroid ointments, and ultraviolet B (UVB) therapy:
- Immunosuppressive medications are aimed to reduce immune system response. People who suffer from autoimmune diseases, such as psoriasis or lupus, may find that taking these drugs help reduce the severity of flare-ups.
- Psoriasis can also be treated well with topical steroids, which affect the immune system as well. This is particularly important when the cream is going to be applied to significant areas of the body.
- Retinoids can help clear up the skin and may be well tolerated by people with HIV. Studies using a retinoid called tazarotene have shown favorable outcomes.
- Other treatment options include tar-containing products, calcipotriene, and calcineurin inhibitors.
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Morar N, Willis-Owen SA, Maurer T, Bunker CB. HIV-associated psoriasis: pathogenesis, clinical features, and management. Lancet Infect Dis. 2010 Jul;10(7):470-8. https://pubmed.ncbi.nlm.nih.gov/20610329/
Alpalhão M, Borges-Costa J, Filipe P. Psoriasis in HIV infection: an update. Int J STD AIDS. 2019 May;30(6):596-604. https://pubmed.ncbi.nlm.nih.gov/30813860/
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