Skin and Mucosal Characteristics of Symptomatic Primary HIV-1 Infection

Abstract

The purpose of this review is to outline the clinical signs of the symptomatic HIV-1 seroconversion, with the emphasis on skin and mucous membranes. Our own experience is discussed in relation to other reports in the literature. Major findings are fever and pharyngitis with several patients also showing nonoozing, superficial ulcers or rather epithelial defects of the oral, genital, or anal mucosa. Uniform skin eruptions usually consist of circumscribed, erythematous, dull to bright red, macular or maculopapular lesions that were oval or rounded in shape ranging from a few millimeters to 1 cm in diameter on the upper thorax, particularly within the collar region and also on the face, forehead, and scalp. Skin lesions are sparse or absent at the periphery of the extremities. In the most typical cases, the exanthema appears following 48–72 h of fever, with a peak during one day, persisting for 5–8 days and a gradual clearing concurrently with the general recovery of the patient. Skin biopsy findings do not assist in diagnosing primary HIV exanthema since the histopathological picture resembles toxicodermia and interface dermatitis of morbilliform viral exanthemas.