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HIV Rash

Last reviewed by Dr. Raj MD on January 12th, 2022.

What is HIV Rash?

Any rash is an area of the skin that is irritated and shows redness, swelling and can be painful or itchy.

An HIV rash is due to medications taken for HIV or due to low immune system. Most rashes that show up for an HIV patient are opportunistic infections. (1)

A rash in any person does not mean HIV infection. This is because many infections or conditions may cause rash. If a person having history of sexual exposure, needle sharing or blood transfusion shows rashes, then further investigation should be done to exclude HIV (9). Sudden appearance of massive rashes in face, shoulders or limbs, without any other particular reason should prompt any clinician to rule out HIV (17).

Opportunistic infections list

When the body’s fighting cells are not fighting anymore, our body is prone to infection by any organisms. Bacterial, viral, fungal and parasitic infections can be commonly seen with HIV infection (15).

The CDC is a great resource when looking into infectious disease. They show a long list of opportunistic diseases on their site. The opportunistic disease is those that take over when the immune system is depleted. They can cause lasting and devastating issues.

Please see the following web page to see the complete list of opportunistic disease noted by the CDC.(2,3,4,5)

https://www.aids.gov/hiv-aids-basics/staying-healthy-with-hiv-aids/potential-related-health-problems/opportunistic-infections/

What are Symptoms of HIV Rash?

Characteristics of an HIV rash will depend greatly on the cause of the rash. Remember that symptoms in one person may not be same as in another (15). Most HIV rashes are opportunistic infections. The most common characteristics are:

  • Blotchy red raised areas
  • Blister-like marks on the skin
  • Raised painful areas
  • Itchy inflamed skin
  • Resembles eczema in many cases (6)
  • Purplish or dark in darker skinned individuals. (7)

What is acute HIV Rash?

In the first stage of HIV (Acute HIV infection), the body tries to fight the infection by producing antibodies (8).

There can be body ache, fever, tiredness and rashes during this stage (9). The rashes usually are flat, reddish but non-itchy (16).  This rash usually may persist till 6 months, or may disappear by itself before that (17).

Please refer : Fever with rash

 

Image 1 : This picture shows a patient who was diagnosed with acute HIV rash on his neck.
Picture Source : encrypted-tbn0.gstatic.com

Does rash occur in any other stage of HIV?

Yes. HIV infection can be broadly divided into three stages. The first stage is Acute HIV infection. During this phase, the body is trying to fight the virus out. Antibodies to HIV are produced inside the body (10).

The second stage is a latent phase where many symptoms will not be shown by the patient as the multiplication of HIV has been slowed down by the body’s immunity (11). In the third stage, the body’s immunity has been destroyed and the virus is creating havoc.

This results in opportunistic infections in the person which may present as rashes (12).

How long does HIV Rash last?

The length of the HIV rash will depend on its cause.

When the rash is due to an infective cause, either bacterial, viral, fungal or parasitic, appropriate medication will clear the organism from the body. This will help in curing the rash (9) (10).

If it is related to a certain medication it may take the time to adjust to the medication or if changed then it will last until the medication is cleared from the system.

What does HIV Rash feel like?

Here again, the symptoms associated with the rash will be depending upon the cause of the rash. In many cases, the rash is associated with itching. Scratching of the rash may lead to infection at the site. If infected, the rash may become painful (12) (13) (14). In some cases, it can be seen that they become pus filled.

Does HIV Rash come and go?

Yes, if the rash is due to the lower immune system the rash may come and go many times. If it is due to medications then with the change of dosage or medication the expectation is that the rash does not continue.

What are HIV skin lesions?

Lesions on the skin can a rash, an ulcer, a wound etc. When we are talking on HIV related skin lesions, these could be rashes, ulcers, nodules, blisters, pustules etc.

The lesion which is shown on the skin of an HIV infected patient is in fact directly due to the cause of the lesion. Mostly these lesions are related to infections (15).

Does HIV Rash itch and burn?

Yes, it may burn or itch, this is not always the case but does happen depending on the cause.

When does HIV Rash appear?

Usually, it appears when the immune system is at its lowest. As said earlier, this occurs mainly in the first stage and the third stage.

Why do I get HIV Rash?

There are various reasons why someone with HIV will get a rash, here are a few of those reasons:

Infections due to low immune system

Medications were taken for HIV- All HIV medications show rash as a common side effect. (1)

Pictures (Images) of HIV Rash

Picture 2 : Armpit rash HIV- The image below shows a candida infection.

Photo Source : www.healcure.org

Figure 3 : HIV rash on face- The blistery type of rash that can appear with HIV rash.
Photo Source : insidetheclinic.com

Image 4 : HIV rash on hands- The rash on the hands is a blotchy raised area.
Picture Source : mddk.com

Figure 5 : HIV rash on arms- This rash is evident when looking close up.
Image Source : images.wisegeek.com

Picture 6 : HIV rash on legs– Here the raised irritated areas are spread out over the legs.
Phot Source : i.ytimg.com

Image 7 : Early HIV rash- This image shows a good example of a blotchy raised rash.
Picture Source : healthylifemed.com

Picture 8 : HIV rash on chest- Here in this picture the patient has the petechial type of red spots.
Photo Source : www.ihealthblogger.com

Figure 9 : HIV rash on the back- In this picture you can see the more blistery type of rash which can be found anywhere on the body.
Image Source : diseasespictures.com

Image 10 : HIV rash on head-Here the blotchy type of rash is seen covering the scalp.
Picture Source : www.bestonlinemd.com

Photo 11 : HIV rash on the neck- In this image, the rash is almost difficult to see on the neck as it may be in early HIV rash.
Image Source : seeyadoctor.com

Picture 12 : HIV rash on penis- All the types of rashes above may be seen in any part of the body including the penile shaft.
Photo Source : itchyrash.files.wordpress.com

Image 13 : HIV rash on the black skin- As you can see the color of the rash itself tend to change with different skin color tones.
Picture Source : www.ihealthblogger.com

Figure 14 : HIV rash on abdomen- The abdomen in this picture is noted to have red blotchy areas which could be diagnosed as HIV rash.
Image Source : 1.bp.blogspot.com

Resources:

  1. https://aidsinfo.nih.gov/education-materials/fact-sheets/22/60/hiv-and-rash
  2. https://www.aids.gov/hiv-aids-basics/staying-healthy-with-hiv-aids/potential-related-health-problems/opportunistic-infections/
  3. https://www.cdc.gov/hiv/basics/livingwithhiv/opportunisticinfections.html
  4. http://www.aidsinfonet.org/fact_sheets/view/500
  5. http://www.healthline.com/health-slideshow/hiv-opportunistic-infections
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3093072/
  7. https://www.ncbi.nlm.nih.gov/pubmed/12342834
  8. http://www.merckmanuals.com/home/skin-disorders/bacterial-skin-infections/cellulitis
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4447481/
  10. http://www.merckmanuals.com/home/infections/viral-infections/shingles
  11. Retrieved from http://www.aidsmap.com/Seroconversion/page/1322973/
  12. http://www.prn.org/index.php/complications/article/common_skin_problems_of_hiv_disease
  13.  https://www.aids.gov/hiv-aids-basics/hiv-aids-101/how-you-get-hiv-aids/
  14. https://aidsinfo.nih.gov/education-materials/fact-sheets/22/60/hiv-and-rash
  15. https://www.cdc.gov/hiv/basics/livingwithhiv/opportunisticinfections.html
  16. https://www.medicalnewstoday.com/articles/315963.php
  17. http://www.bestonlinemd.com/characteristics-of-hiv-rash/

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