At the end of 2001 over 40 million men, women, and children were estimated to be living with human immunodeficiency virus (HIV) infection. This virus is an RNA retrovirus that infects certain white blood cells, CD4+ cells. HIV infection leads to a profound alteration of the immune system, putting the infected person at risk for several different types of skin diseases. One of the most common skin diseases experienced by HIV-infected individuals is seborrheic dermatitis.
Cause
Seborrheic dermatitis is a common disease that affects 2%-4% of the general population. However, up to 85% of HIV-infected people experience seborrheic dermatitis at some time after they acquire the infection. The cause of seborrheic dermatitis is unknown, but many investigators believe the yeast, Pityrosporum ovale, plays a role in the disease. It is further postulated that the alteration of the immune system in HIV-AIDS changes the way the skin responds to this yeast leading to the higher rate of infection.
Appearance
Seborrheic dermatitis causes redness of the skin, which produces a yellow, waxy scale or flake. In people without HIV-AIDS, the rash of seborrheic dermatitis occurs mainly on the scalp, and around the eyebrows, ears, and mustache. In HIV-infected individuals, the rash also appears on the chest, back, armpits, and groin.
Treatment
Seborrheic dermatitis is treated with antifungal shampoos and topical corticosteroids. These treatments are also used for HIV-infected individuals who need to use them frequently. People with HIV-AIDS who are being treated with antiviral therapy have fewer outbreaks of seborrheic dermatitis. In many cases, the severity of the rash corresponds with the degree of clinical deterioration.
Seeing a Doctor
A health care provider should evaluate cases of seborrheic dermatitis that do not respond to typical over-the-counter treatments. However, this does not necessarily imply that a person is HIV-positive. Someone with HIV-AIDS should notify their physician if they have a red, flaking rash that is getting worse so they can get appropriate treatment.
