Rash as a sign of HIV disease




Under the term rash (Rash) one understands a long-lasting or regressive change of individual skin areas. Various triggers cause skin irritation that is accompanied by redness, itching and / or burning.

General information about HIV

The HI virus (human immunodeficiency virus; HIV) is one of the so-called retroviruses. They have a single-stranded genome (so-called RNA) and have to convert this into double-stranded DNA before they can reproduce. HIV is a pathogen that causes the immune disease AIDS. Despite long-term, targeted educational and preventive measures (prophylaxis) the annually occurring new cases follow an upward trend. HIV is mainly transmitted through the exchange of body fluids such as blood and semen. Infection through vaginal secretions, brain water and breast milk cannot be ruled out. The majority of those infected report transmission of the HI virus through unprotected traffic and / or intravenous drug use.

Contagion from blood products and blood products (such as coagulation factors) has decreased significantly in recent years, but it cannot be completely ruled out today.

The risk of transmission to an unborn child from an HIV-positive mother during pregnancy or childbirth is approximately 15-30%. However, drug treatment during pregnancy can largely reduce this risk.

For general information on virus infections, see: Viral infection


The most common symptom of an HIV infection is the occurrence of sometimes very high levels fever. Around 90 percent of all infected people develop attacks of fever in the first few months after being infected. Also noticeable, palpable Swelling of the lymph nodes are not uncommon in the first time after the HIV infection. It arise Thickening of the lymph nodes in the Neck, armpit and / or throat area.

About 70 percent of all HIV sufferers complain of severe Sore throat and a strong one skin rash (so-called HIV rash; HIV skin rash). The rash in HIV knows one small-spotted-nodular Structure, one speaks of a maculopapular skin rashthat with the during a measles or Scarlet fever infection is comparable. The rash from HIV occurs in most cases on the face and trunk, but in some infected people the papules can also be found on the extremities (arms and legs). The rash just described most likely suggests a recently acquired HIV infection (so-called Stage A) and is characterized by a light itch the affected body regions. A few days (usually as early as 24 to 48 hours) after the maculopapular rash appeared, the papules suddenly disappear, at which point the itching also gradually subsides. In rare cases, ulcer-like inflammations subsequently develop (Ulcers) in the area of ​​the oral mucosa.

Itchy skin rash indicating HIV infection

Rashes associated with HIV that are very itchy appear rather seldom on. However, if you have newly developed neurodermatitis, you should always consider an underlying HIV infection. Even so, it is not necessary to screen for HIV every patient with a new itchy rash. Several factors should match (e.g. frequent accompanying infections, younger age, more frequent partner changes, etc.) before HIV screening is carried out.

You might also be interested in this topic: Itchy rash

Skin rash as an acute phase / primary infection

In the acute phase of HIV infection, more than half of those affected experience temporary symptoms.
Symptoms appear about one to two weeks after the primary infection; the symptomatic phase of acute HIV infection rarely lasts longer than 14 days. These are usually not specific to an HIV infection, but can also occur with other viral infections such as influenza or Pfeiffer's glandular fever.
Very often fever, sore throat (Pharyngitis) and swelling of the lymph nodes in the neck, neck and armpits.

A skin rash is also typical of the acute phase of HIV infection; around two thirds of those newly infected develop a so-called rash. This rash usually appears on the face, chest and back, but it is rarely seen on the arms and legs.
In most cases, the rash looks blotchy and small nodules develop, which is known in medicine as a maculopapular rash.

Often times, the rash will go away as soon as 24 to 48 hours after it started. In rarer cases, the rash spreads not only to the skin but also to the lining of the mouth. Then small sores develop in the mouth (ulcerous inflammation of the lining of the mouth). Since the symptoms of the acute phase can be very diverse and unspecific, the appearance of a rash in connection with fever within a month after a risk exposure (e.g. unprotected intercourse with a person infected with HIV) provide a crucial clue for the diagnosis.

Localization of the rash

Rash on the face as a sign of HIV infection

HIV-associated rashes usually occur on the face and trunk.
On the face, the rash is usually red or brown in color and forms small nodules. In most cases, it doesn't come to one itching, the affected areas feel rather sore.

The rash on the face only occurs during the symptomatic phase of HIV infection and usually goes away within a few weeks. Medicines and creams can be prescribed for severe discomfort against the rash on the face.
However, simple tips can help alleviate the symptoms. For example, direct sunlight, warmth and dry air should be avoided to avoid making the rash worse.
Hot showers should also be avoided, it is better to clean your face with cold water and without detergent. If there is an itchiness, something can Hydrocortisone cream or Care ointments Provide relief.

The skin on the face often dries out and becomes flaky. If there are unusual changes in the skin rash on the face or if the sore spots become inflamed, the doctor treating you should be consulted immediately.

Rash on the chest as a sign of HIV infection

Skin rashes on the breast, which are connected with an HIV or AIDS disease, are due to the early and good initial treatment today kinda rare become. Nonetheless, if the diagnosis is late or treatment is hesitant, lesions may appear on the body, including the chest.
These lesions usually do not itch and do not make any other complaints. But they impress with theirs dark blue livid coloring. The stains can sometimes take up the size of a EUR 2 piece, but they can also be much smaller.

Rash on the arms as a sign of HIV infection

An HIV infection causes no symptoms for a long time and is sometimes only detected by a routine blood test. The first signs that are suspicious of HIV infection are frequent infections, fatigue, weight loss and poor performance. Skin manifestations usually occur relatively late in the case of untreated HIV infection and already represent the outbreak of disease (AIDS). Skin abnormalities in the sense of dark-colored skin lesions only appear when the full-blown AIDS breaks out. However, the first early signs can appear suddenly Neurodermatitis be on the arm or hand or constant ulceration of the mucous membrane that is difficult to heal.

Rash on the legs, a sign of HIV infection

Rashes that occur as a result of HIV infection can eventually every area attacked the skin. Sometimes skin abnormalities in the area of ​​the legs can also occur. If AIDS has already broken out, there is dark-livid discoloration of the skin in the area of ​​the legs.

Today you can only see these skin symptoms Rare, as early and good treatment of the HIV viral load tends to delay an outbreak of HIV infection. Atopic dermatitis, which is associated with HIV, can also occur in the legs.

Also read our topic: Red spots on the legs


Skin rashes occur in around 70% of those affected.

The question of whether the abnormalities are an HIV-induced rash can ultimately only be answered by a virus-proof test. This fact is due to the fact that both the rash and the other first symptoms are quite unspecific and can occur in a variety of different infectious diseases. The greatest indication of the presence of an HIV infection is the occurrence of the symptom combination of fever and skin rash within one month of exposure to risk. If there is even the slightest suspicion of infection, it is advisable to have an HIV test carried out as soon as possible.

Up to 50 percent of all new infections result from the exchange of body fluids with someone who is also freshly infected. A major problem in HIV diagnosis is the fact that no specific antibodies can be detected during the first phase, but suspected infection can be checked by testing for HIV RNA.

Do you have an HIV infection? Find out very easily - also possible at home - with the HIV rapid test. Further information on this topic can be found at: HIV rapid test - you should know that!
Also read: Is my rash contagious?

HIV rash after medication

Despite the weakened immune system, HIV-infected people can suddenly develop a small, nodular rash (known as a nodular rash after and / or while taking various medications) Drug eruption) come. In such cases, it is particularly important to rule out further virus infections, such as measles, Scarlet fever or Pfeiffer's glandular fever. In addition to the maculopapular rash, HIV-related allergic reactions to drugs can also cause death (necrosis) come from skin areas.
These symptoms usually appear within the first four weeks after taking the medication and require immediate discontinuation of the medication.

In addition, HIV sufferers can also have one Granuloma annulareto develop a benign infectious skin disease. It manifests itself in growing, reddish, coarse nodules (papules) that appear on the back of the feet and hands and over the joints and appear in a ring.
You can find more information on the topic here: Granuloma annulare, rash on the foot and rash on the hand

How long does the rash last?

The rash in a fresh HIV infection lasts just like the other non-specific symptoms such as fever or Lymph node swelling usually no longer than two weeks.
However, these symptoms are often not noticed because they don't always appear or they don't all come together. The severity and duration of the rash can also vary individually.

Of the Rash on back, Abdomen or chest usually appear a few days after being infected with the HI virus. The viruses multiply at a rapid pace and the rash is a sign of the body's own defense cells trying to fight the HIV virus.

Since a rash is not specific to an HIV infection, but can also occur with many other viral infections, it is particularly important to correctly assign the rash to an HIV infection at an early stage. It is assumed that the risk of contracting the HI Virus is very high in infected people who are in the acute phase. For this reason, a rash should be investigated immediately after adequate risk exposure.