The unwelcome trio: HIV plus cutaneous and visceral leishmaniasis

Abstract

Leishmania/Human Immunodeficiency Virus (HIV) coinfection has emerged as an extremely serious and increasingly frequent health problem in the last decades. Considering the insidious and not typical clinical picture in presence of immunosuppressive conditions, the increasing number of people travelling in endemic zones, the ability to survive, within both human and vector bodies, of the parasite, clinicians and dermatologists as the first line should be aware of these kind of "pathologic alliances," to avoid delayed diagnosis and treatment. In this setting, the occurrence of cutaneous lesions can, paradoxically, aid the physician in recognition and approaching the correct staging and management of the two (or three) diseases. Treatment of these unwelcome synergies is a challenge: apart from the recommended anti-retroviral protocols, different anti-leishmanial drugs have been widely used, according with the standard guidelines for visceral leishmaniasis (VL), with no successful treatment regimen still been established.

Unusual presentation of mucocutaneous leishmaniasis in HIV-infected patient

“…Impaired immunity in HIV infection causes the reactivation of latent Leishmania infection, whereas leishmaniasis can also promote HIV virus replication and increases progression to AIDS. [8] Mucocutaneous involvement is not a common presentation in old world leishmaniasis, especially nasal involvement. Mucocutaneous leishmaniasis is usually caused by new world species of Leishmania , but it can also be caused by Leishmania aethiopica and rarely other Leishmania species such as Leishmania tropica .…”

HIV‐associated psoriasis: Epidemiology, pathogenesis, and management

“…On the other hand, the introduction of the highly active antiretroviral therapy or combined antiretroviral therapy (cART) dramatically changed the natural course of both HIV and psoriasis in PLWH, leading to an improvement of quality and duration of life (D'Aleo et al, ; Facciolà et al, ; Guarneri et al, ; Nunnari et al, ; Pinzone et al, ). Therefore, it is necessary to find newer and safer therapies to treat PLWH affected by psoriasis.…”

“…Since the beginning, the human immunodeficiency virus (HIV) epidemics were accompanied by an increased incidence of a number of other diseases, associated with immune system disorders. People living with HIV (PLWH) are, as a matter of fact, affected by a higher incidence of cancers, other infectious diseases, non‐AIDS‐related pathologies and rheumatological disorders than the general population (D'Aleo et al, ; Facciolà et al, ; Guarneri, Tchernev, Bevelacqua, Lotti, & Nunnari, ; Nunnari et al, ; Pinzone, Berretta, Cacopardo, & Nunnari, ). Moreover, HIV‐positive patients are commonly affected by skin disorders, which are often associated with high morbidity and mortality (Amerio et al, ; Khambaty & Hsu, ).…”

Malignant melanoma in HIV: Epidemiology, pathogenesis, and management

“…In addition, HAART has increased people living with HIV (PLWH) survival turning the infection in a chronic disease, burdened with an enhanced rate of some non-AIDS-related diseases such as cardiovascular, neurological, renal, dermatological, and bone disorders (Atteritano et al, 2018;Ceccarelli et al, 2019;Guarneri, Tchernev, Bevelacqua, Lotti, & Nunnari, 2016;Venanzi Rullo et al, 2019). Moreover, the prolonged survival brought an increase in the incidence of AIDS (ADCs) and non-AIDS (NADCs) determined cancers Facciolà et al, 2018).…”