What are the cutaneous manifestations of mycobacterial infections in HIV disease?

Updated: Apr 19, 2019
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD  more...
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Answer

Answer

Mycobacterium tuberculosis; M avium-intracellulare complex (MAC); and, rarely, M kansasii may present as acneiform papules and indurated crusted plaques.

MAC, a common opportunistic pathogen among patients with AIDS, usually causes disseminated disease involving the lungs, lymph nodes, and gastrointestinal tract. Primary cutaneous infections with MAC are extremely rare; most cutaneous lesions are caused by dissemination. Cutaneous manifestations thus far reported include the following:

  • Scaling plaques

  • Crusted ulcers

  • Ecthymalike lesions

  • Verrucous ulcers

  • Inflammatory nodules

  • Panniculitis

  • Pustular lesions

  • Draining sinuses

Localized skin involvement resembling sporotrichosis is unusual. Primary cutaneous MAC infection manifesting as sporotrichosislike lesions was described in a patient with AIDS. [34]

The possibility of coinfections, which may be multiple, should be kept in mind. Coinfection with B quintana, MAC, and CMV has been reported in an AIDS patient. [35]

In patients with HIV, M haemophilum can also present as violaceous draining nodules and superficial ulcers on the extremities, trunk, head, and genitalia.


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