What is the association of psoriasis and HIV infection?
Psoriasis and psoriatic arthritis tend to occur late in the course of HIV infection. The full spectrum of psoriaform skin manifestations can be observed in the same patient. ART is very effective for both psoriasis and psoriatic arthritis. Methotrexate, biologics, and phototherapy are reserved for refractory skin or joint involvement because they can precipitate worsening immunosuppression or recurrent infections (see Question #9). Any patient with a severe unexplainable flare of psoriasis, different subtypes of psoriasis concurrently present, or the onset of psoriasis that is unresponsive to conventional therapy should be screened for HIV infection. In patients with established HIV who develop widespread psoriaform lesions, cutaneous T-cell lymphoma should also be included in the differential.
