Recently, the occurrence of pityriasis rubra pilaris (PRP) has been reported in patients with HIV infection. It presents different clinical features, and has a poorer prognosis, than the classical adult type of PRP. We report the occurrence of severe PRP in an HIV-infected patient, and review the previously reported cases of this association. We propose the designation of a new category of PRP (type 6), characterized by the presence of HIV infection, usually without immunosuppression, a poor prognosis and response to treatment, and the development of nodulocystic and lichen spinulosus lesions.

Mucocutaneous leishmaniasis is a rare disease in Europe. Relapses after treatment are more frequent than in visceral leishmaniasis. HIV patients infected by Leishmania have frequently visceral involvement, and responses to treatment are poor. Mucocutaneous leishmaniasis in HIV-infected patients has rarely been reported. A patient with centrofacial granuloma was diagnosed as having mucocutaneous leishmaniasis; simultaneously HIV infection was detected. To our knowledge this is the first case acquired in Europe. Intravenous meglumine antimonate 20 mg/kg/day for 28 days was proven to be useful.

We report a 25-year-old HIV-positive man with a past medical history of disseminated cytomegalovirus (CMV) infection, who developed cutaneous lesions during a disseminated mycobacterium infection. The histological changes of CMV and acid-fast bacilli were seen on histopathology of the lesions. Cultures were positive for M. tuberculosis and M. avium-intracellulare (MAI). CMV is frequently isolated from HIV patients, but skin involvement is rare. The association of CMV and mycobacteria can occur in cutaneous lesions of AIDS patients, but concurrent cutaneous involvement of CMV, M. tuberculosis, and MAI is unusual. These findings emphasize the polymorphous presentation of infectious disorders in AIDS patients and the need for multiple biopsies and for special stains in such patients.

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