Psoriasis is a relatively common skin problem. It is an auto-immune condition, which means that the immune system is attacking the body's own cells. People with HIV who have a history of psoriasis may find that HIV makes it worse, but the condition can also occur in people with no prior history.

A small proportion of HIV-positive people with psoriasis also develop an associated arthritis, called psoriatic arthritis.

Symptoms

Psoriasis causes a flaky red rash rather like seborrhoeic dermatitis, but somewhat more scaly. It is also more likely to affect the armpits, groin, elbows, knees and lower back. On the hands and feet it appears as white spots under the skin, known as pustular psoriasis. In some cases it can affect the joints, especially in the fingers, causing pain and swelling.

Treatment

As with other HIV-related conditions, treatment with highly active antiretroviral therapy (HAART) may improve or resolve psoriasis in HIV-infected people.

Specific treatments are also available. Auto-immune problems are usually treated with drugs that suppress the immune system. In the case of psoriasis, medium to high potency steroid creams are used. Other creams containing vitamin A and vitamin D derivatives, anthralin, coal tar, and salicylic acid may also be effective.

If creams do not work, stronger drugs such as etretinate or acitretin may be used. Phototherapy may also be beneficial.