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1. What is AIDS?
The Acquired Immune Deficiency Syndrome (AIDS) is the loss of the
body's ability to fight infections due to infection by a virus called
Human Immunodeficiency Virus (HIV). Since first recognized in 1981,
AIDS has been found to be a major health problem all over the world.
The AIDS virus was found in 1983. Infection with this virus is usually
spread sexually or through blood and blood products. The virus is
not transmitted by casual household contact such as sharing beds,
baths, or toilets. There is no evidence that the virus is transmitted
by casual personal contact. A person can be infected with HIV for
several years before the problems of AIDS occur. The development
of the life-threatening complications of AIDS are due to the virus'
destruction of white blood cells. These cells are essential for
the body's natural immune system. AIDS patients can also develop
an unusual cancer known as Kaposi's sarcoma. This cancer begins
as one or more painless pink to purple-colored flat blotches and
bumps on the skin or in the mouth.
2. Who is at risk?
HIV is spread by sexual secretions and blood. When AIDS was first
recognized in the United States, most patients with the disease
were young, sexually active homosexual men. The disease has also
been seen in heterosexual men and women, intravenous drug abusers,
hemophiliacs and other people who have received blood transfusions,
and in heterosexual partners of AIDS victims. Children born to mothers
infected with HIV may be infected and later develop AIDS.
3. How safe is the blood
supply?
Since 1985, reliable blood tests to detect antibodies to HIV have
been used to screen the nation's blood supply. These tests have
almost eliminated the risk of getting AIDS through blood transfusions.
These screening tests are also available through physicians or the
local health department for anyone who thinks that they may have
been exposed to HIV. The test is highly reliable and can show whether
there has been previous exposure to HIV.
4. What is Kaposi's
Sarcoma?
A common skin problem in AIDS patients is Kaposi's sarcoma. This
rare form of cancer develops in about 20% of cases. The lesions
of Kaposi's sarcoma do not hurt or itch. They can appear anywhere
on the skin or in the mouth. Kaposi's sarcoma lesions vary from
pink to dark red, purple or brown. They are often mistaken for insect
bites, birthmarks, or bruises. They can range in size from a pinhead
to the size of a large coin. The lesions frequently continue to
develop into thickened bumps and even large tumor growths. There
may be one or more lesions, with new ones developing during the
course of the illness. Occasionally, Kaposi's sarcoma involves lymph
nodes and internal organs such as the spleen, liver, stomach/bowel,
or the lungs. Individual lesions can be removed by treatment with
local x-ray therapy, freezing treatments, surgical excision, or
injection with special medication. In patients with widespread disease,
chemotherapy may be helpful.
5. What about Herpes
Simplex in AIDS patients?
Herpes simplex virus may cause recurrent infections. Herpes Simplex
Type I commonly causes sores around the nose and mouth that are
sometimes called "fever blisters" or "cold sores."
Herpes Simplex Type II will cause recurrent sores near the genital
or anal areas. Occasionally either of these infections can occur
in the eyes or other areas of the skin. The involved area usually
becomes red first and there is often a sensation of burning, itching,
tingling or pain. Clusters of tiny blisters then form and break
leaving small ulcers that crust over or develop scabs. Herpes lesions
usually heal within five to ten days. Patients with HIV experience
often have more severe outbreaks with large, painful ulcers that
increase in size and may last for weeks. Herpes infections can spread
into the body causing fever, mental confusion, headaches, and weakness
that may require hospitalization. Dermatologists may prescribe an
oral or intravenous anti-viral medication for these severe episodes
of herpes simplex infections.
6. What about Herpes
Zoster (Shingles) in AIDS patients?
Herpes zoster is a skin eruption due to reactivation of the virus
that causes chicken pox in childhood. The eruption appears in a
band-like pattern on one side of the body. The involved area first
becomes tender and red, and there may be deep throbbing pain. Clusters
of blisters appear and soon burst, leaving ulcers that become crusted.
Shingles can be the first sign of HIV infection or of a weakened
immune system. This condition can last for weeks and can spread
to other parts of the body, with blisters that look like chicken
pox. Oral anti-viral medications may help dry up the blisters and
ulcers. For patients with severe or widespread herpes zoster, hospitalization
may be needed to provide intravenous, anti-viral medication.
7. What about Molluscum
Contagiosum and AIDS?
Molluscum contagiosum is commonly seen in children and less frequently
among sexually active young adults. The viral lesions appear as
smooth, pearl or waxy skin-colored bumps that vary from pin-sized
to pea-sized. The bumps usually have central cores that are filled
with a white cheese-like material. They are not painful and do not
usually itch. Molluscum contagiosum frequently occurs on the skin
of patients infected with HIV. Molluscum lesions may develop on
any skin surface. Dermatologists treat molluscum by freezing or
scraping the lesions.
8. What about warts
and AIDS?
Warts are common, benign, painless growths that are caused by the
human papilloma virus. They can occur anyplace on the skin, especially
on the feet, hands, face, genital and anal regions. When warts occur
in HIV-infected individuals, they tend to be more numerous, bigger
and widespread. The warts seen in HIV patients are often resistant
to standard treatments. Recurrences after treatment are especially
common.
9. What is "Hairy"
Leukoplakia of the mouth?
Oral "Hairy" leukoplakia is an unusual condition that
causes small, white, fuzzy patches most often on the tongue. "Hairy"
leukoplakia is believed to be caused by a member of the herpes family
of viruses known as the Epstein-Barr virus. "Hairy" leukoplakia
resembles and can be confused with "thrush" – a
yeast infection of the mouth. The lesions of the "hairy"
leukoplakia are symptom-free. It is an important sign that the patient
is infected with HIV.
10. What about yeast
infections?
Yeast infections (thrush) involving the mouth, vagina, and skin
folds under the arms and in the groin are caused by candida albicans.
They frequently and repeatedly occur in many patients infected with
HIV. Yeast infections in the mouth appear as white curd-like patches
on the tongue and inner surfaces of the cheeks that are easily scraped
off. This infection commonly causes a soreness of the mouth or throat,
difficulty in swallowing and loss of taste. The infection can also
spread down the throat causing a burning sensation in the chest
upon swallowing.
Both adults and infants with AIDS frequently develop
a yeast infection seen as a severe itchy red rash in the skin folds
of the groin. The yeast infection often spreads onto the genitals,
buttocks and thighs. In some HIV infected patients, the yeast infection
is resistant to treatment or often reappears when treatment is stopped.
Women who are immune-suppressed can develop severe and treatment-resistant
vaginitis. Oral or intravenous medication may be required for these
yeast infections.
11. What is Cryptococcosis?
This unusual human infection is caused by another fungus –
cryptococcis neoformans – often found in pigeon droppings.
Cryptococcosis, a potentially fatal infection, frequently involves
the lungs, brain and spinal cord. Cryptococcosis rarely involves
the skin; however when it does, it appears as multiple tiny pus
bumps resembling acne, anyplace on the body. In severe cases, hospitalization
for intensive treatment including intravenous drugs is required,
especially if infection has spread to the brain and spinal cord.
12. What about Seborrheic
Dermatitis and AIDS?
Seborrheic dermatitis is a flaky, red, itchy rash often on the face,
involving the cheeks, forehead, eyebrows, nose and ears. On the
scalp it can look like "dandruff." The rash can be seen
on the chest and groin. In HIV-infected patients with seborrheic
dermatitis, the condition may require stronger treatment.
13. What about Psoriasis
and AIDS?
HIV-infected patients with psoriasis often experience worsening
of the skin condition. The flare-up of psoriasis often includes
an increase in the size and number of the scale-covered, salmon-pink
patches of psoriasis that can appear all over the skin, and are
often especially severe on the scalp, elbows and knees. Some patients
develop thick scaly filled blisters. Severe generalized psoriasis
may occur involving the total body with widespread itching, redness
and scaling. Methotrexate, a prescription medication sometimes used
by dermatologists for patients with severe psoriasis could be dangerous
in patients with HIV infection, since it could further suppress
the immune system.
14. What is "Itchy
Red Bump Disease"?
One skin problem in individuals with HIV who otherwise feel well,
is widespread itching with tiny red bumps, often the size of a small
pea. Larger patches of hives sometimes occur as well. The persistent
itching can be very uncomfortable and difficult to control, since
it often responds poorly to large doses of antihistamines and topical
medications, including creams containing cortisone.
15. What is a common
skin problem in AIDS patients?
Many patients with HIV develop multiple small pimples or pustules
around hair follicles on the chest and back, and sometimes on the
face, scalp, legs and buttocks as well. This acne-like skin rash
can also be very itchy, and like hives, can cause patients to scratch
enough to cause bleeding and secondary infections. This condition,
known as folliculitis, is usually treated with a combination of
antihistamines and topically applied drying lotions used for acne.
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