Comorbid diagnoses for severe psoriasis
Are there specific comorbid diagnoses to consider when someone presents acutely with severe psoriasis or PsA?
In this scenario, one needs to consider concurrent human immunodeficiency virus (HIV) infection. Clinically, psoriasis or PsA associated with HIV infection is more aggressive and difficult to control with traditional medical therapy. In the modern era of highly active antiretroviral therapy (HAART) for HIV, this is seen less frequently, as psoriasis is often associated with T cell counts of <100 cells/μL. Treatment for psoriasis and PsA associated with HIV involves treating HIV with antiretroviral drugs in addition to treating the skin and joint disease. Case reports suggest that anti-TNF agents may be relatively safe in this population when used in conjunction with HAART