Synonym
Exanthema
Definition
The term skin rash (exanthema) refers to a long-lasting or receding change in individual areas of the skin. Various triggers cause skin irritation, which is accompanied by redness, itching and/or burning. The HI virus (Human Immunodeficiency Virus; HIV) is counted among the so-called retroviruses.
They have a single-stranded genome (so-called RNA) and must convert this into double-stranded DNA before they can multiply. HIV is a pathogen that triggers the immune disease AIDS. Despite many years of targeted education and prevention measures (prophylaxis), the annual number of new cases of the disease follows an upward trend.
HIV is mainly transmitted through the exchange of body fluids such as blood and sperm. Infection through vaginal secretions, cerebral fluid and breast milk is also not excluded. A large proportion of those infected report transmission of the HI virus through unprotected transport and/or intravenous drug use.
Infection through blood preserves and blood products (such as coagulation factors) has decreased significantly in recent years, but cannot be completely ruled out even today. The risk of transmission to an unborn child by an HIV-positive mother during pregnancy or birth is approximately 15-30%. However, this risk can be reduced to a large extent by drug treatment during pregnancy.
General information on viral infections can be found here: Viral infectionThe most common symptom of an HIV infection is the occurrence of sometimes very high fever. Around 90 percent of all infected persons develop fever spikes in the first months after infection. Even noticeable, palpable swelling of the lymph nodes is not uncommon in the first months after HIV infection.
Thickening of the lymph nodes in the neck, armpit and/or neck area develops. Approximately 70 percent of all HIV patients complain of severe pharyngitis and a very pronounced skin rash (so-called HIV exanthema; skin rash HIV). The rash of HIV has a small spotty, nodular structure and is called maculopapular rash, which is comparable to that of measles or scarlet fever.
The HIV rash usually occurs on the face and trunk of the body, but in some infected persons the papules can also be found on the extremities (arms and legs). The rash just described is most likely to be indicative of a recently acquired HIV infection (so-called stage A) and is characterized by a slight itching of the affected body regions. A few days (usually as early as 24 to 48 hours) after the appearance of the maculopapular rash, the papules suddenly disappear, and at this time the itching also decreases increasingly.
In rare cases, ulcerous inflammations (ulcers) develop in the area of the oral mucosa. Skin rashes that are associated with HIV and are very itchy occur rather rarely. However, in the case of a newly occurring neurodermatitis, one should always consider an underlying HIV infection.
Nevertheless, it is not necessary to examine every patient with a new itchy rash for HIV. Several factors should coincide (e.g. accompanying frequent infections, younger age, frequently changing partners, etc.) before HIV screening is performed.
In the acute phase of HIV infection, more than half of those affected experience temporary symptoms. The symptoms appear about one to two weeks after the primary infection, rarely the symptomatic phase of acute HIV infection lasts longer than 14 days. These are usually not specific to HIV infection, but can also occur in other viral infections such as influenza or in Pfeiffer’s glandular fever.
Very often there is fever, pharyngitis and swelling of the lymph nodes in the neck, throat and armpits. A skin rash is also typical of the acute phase of HIV infection; about two thirds of newly infected persons develop a so-called exanthema. This rash usually appears on the face, chest and back, and is rarely seen on the arms and legs.
In most cases the rash looks blotchy and small nodules are formed, which in medicine is called maculopapular rash. Often the rash disappears within 24 to 48 hours after it has appeared. In rare cases the rash spreads not only on the skin but also on the oral mucosa.Then small inflammations in the mouth (ulcerous inflammation of the oral mucosa) develop. Since the symptoms of the acute phase can be very varied and unspecific, the occurrence of a skin rash in conjunction with fever within one month of a risk contact (e.g. unprotected intercourse with an HIV-infected person) can provide a decisive indication for diagnosis.
