The challenge of evaluating and treating HIV related cutaneous disease.

t was the unusual appearance of Kaposi sarcoma in the skin of young homosexual males and the coexistence of pneumocystis pneumonia that led to the description of AIDS in the early 1980s. Since then protean manifestations of cutaneous disease are recognised. The presence of skin disease can sometimes be the first indicator of HIV infection. Furthermore, the appearance of some cutaneous infections can serve as a marker of HIV disease progression. Many of the diseases are either exaggerated examples of inflammatory or infectious disorders and can be difficult to diagnose. Others, such as bacillary angiomatosis and Epstein Barr related oral hairy leukoplakia were first described in a HIV setting. The relative ease of examination and access to biopsy of the skin has proven invaluable.