Approach to Rash in a Patient with HIV

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Blistering & Skin Loss• Often with systemic abnormalities• SJS = skin loss 30% of BSA• Erythema Multiforme - Major• MortalitySeverity of Illness Scale - MortalityBSA, body surfaceareaBr J Clin Pharmacol 2010;71:672
Case 1 - Continued• Patient reports to clinic & has not takentoday’s s medications, as instructed• History: Feverish. Mild nausea. Safe sex.• Exam: T 101. Only other abnormality is skin.• Labs – Cr 1.6. ALT 101, AST 80, Bili 0.8.WBC 4.2 (ANC 2800, AEC 450, ALC 950),Hgb 13.1, PLT 88Photo from Todd, DermatolClin 2006;24:459
Page 1 and 2: Approach to Rash in aPatient with H
Page 3 and 4: Discussion Topics• Causes & types
Page 5 and 6: Case 1• Put on Epzicom (abacavir/
Page 7 and 8: Skin Disorders Commonin HIV + Perso
Page 9 and 10: Cutaneous Drug Reactions:What Type
Page 11 and 12: Cutaneous Drug Reaction:Moderate Se
Page 13: Severe/Life-ThreateingCutaneous Dru
Page 17 and 18: ARV drugs frequentlyassociated with
Page 19 and 20: Abacavir HSRFrom FDA-approved packa
Page 21 and 22: Abacavir HSR• Most signs/symptoms
Page 23 and 24: Darunavir• Rash, ~7%.• Most mil
Page 25 and 26: PhotodermatitisMaurer, TA. Topics H
Page 27 and 28: Eosinophilic FolliculitisMaurer TA
Page 29 and 30: Rashes Caused byInfections
Page 31 and 32: Secondary Syphilis
Page 33 and 34: Varicella-Zoster Virus (VZV)HIV Web
Page 35 and 36: What would be an appropriatenext st
Page 37 and 38: Cutaneous Drug Reaction:Patient Cou
Page 39 and 40: What do you recommend aboutfuture u
Page 41 and 42: What would be theappropriate next s
Page 43 and 44: Approach to EfavirenzRash• Usuall
Page 45 and 46: What would be theappropriate next s
Page 47 and 48: Patient BF
Page 49 and 50: Case 3: Continued• Seen by primar
Page 51 and 52: Patient BF’s Diagnosis:Neurosyphi
Page 53: Nevirapine Rash• More common in w

Approach to Rash in a Patient with HIV

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