A Case Report: The Clinical Features and Treatment Challenges of HIV-associated Psoriasis

Teffy Nuary, Anissa Anjani, Anna Ariane, Lili Legiawati, Sri Adi Sularsito, Shannaz Nadia Yusharyahya, Rinadewi Astriningrum

2019

Abstract

Psoriasis is a chronic inflammatory skin disease, characterized by complex alterations in epidermal growth, differentiation as well as multiple biochemical, immunologic, and vascular abnormalities. The prevalence of human immunodeficiency virus (HIV)-associated psoriasis, and HIV-associated psoriatic arthritis may or may not be the same as in the general population. Misleading, unusual clinical presentations, severe disease, and frequent exacerbations are characteristicfindings.Many effective drugs for psoriasis and psoriatic arthritis are immunosuppressive agents. Therefore, the treatment for the HIV-infected patient is more challenging. A 64-year old female, the HIV-infected patient, was hospitalized because of severe generalized skin rash (92% of BSA, PASI: 28.2) with scaling. She diagnosed with HIV 7 years ago with a CD4 count of 500 cells/uL. The patient took antiretroviral therapy (lamivudine, nevirapine, and tenofovir) regularly. She was diagnosed with erythrodermic psoriasis and psoriatic arthritis. After the risk of opportunistic infection was eliminated, she receivedmethotrexate (MTX) 7.5 mg/week, and the dose was increased into 10 mg/week.Two months following the treatment, there was clinical improvement (4% of BSA and PASI: 2), without the presence of any opportunistic infections and MTX’s adverse events. Although there are limited data on the efficacy and safety of systemic immunosuppressive agents for the treatment of psoriatic disease in HIV-positive patients,adequate concomitant antiretroviral therapy and close monitoring for the signs and symptoms of infectionmight reduce the likelihood of acute infection.

Paper Citation

in Harvard Style

Nuary T., Anjani A., Ariane A., Legiawati L., Sularsito S., Yusharyahya S. and Astriningrum R. (2019). A Case Report: The Clinical Features and Treatment Challenges of HIV-associated Psoriasis.In Proceedings of the 2nd International Conference on Tropical Medicine and Infectious Disease - Volume 1: ICTROMI, ISBN 978-989-758-469-5, pages 282-285. DOI: 10.5220/0009986802820285

in Bibtex Style

@conference{ictromi19,
author={Teffy Nuary and Anissa Anjani and Anna Ariane and Lili Legiawati and Sri Adi Sularsito and Shannaz Nadia Yusharyahya and Rinadewi Astriningrum},
title={A Case Report: The Clinical Features and Treatment Challenges of HIV-associated Psoriasis},
booktitle={Proceedings of the 2nd International Conference on Tropical Medicine and Infectious Disease - Volume 1: ICTROMI,},
year={2019},
pages={282-285},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0009986802820285},
isbn={978-989-758-469-5},
}

in EndNote Style

TY - CONF

JO - Proceedings of the 2nd International Conference on Tropical Medicine and Infectious Disease - Volume 1: ICTROMI,
TI - A Case Report: The Clinical Features and Treatment Challenges of HIV-associated Psoriasis
SN - 978-989-758-469-5
AU - Nuary T.
AU - Anjani A.
AU - Ariane A.
AU - Legiawati L.
AU - Sularsito S.
AU - Yusharyahya S.
AU - Astriningrum R.
PY - 2019
SP - 282
EP - 285
DO - 10.5220/0009986802820285