Article information
Abstract
Dermatologists face diagnostic and therapeutic difficulties when psoriasis coexists with human immunodeficiency virus (HIV) infection.
This article will review some of the aspects of this coexistence from the epidemiologic, pathogenic, histopathologic, clinical, and prognostic point of view. The main skin diseases that should be included in the differential diagnosis are described. Also analyzed are the different therapeutic options in these patients according to the degree of immunodeficiency. Possibilities include antiretroviral treatment, topical treatment, retinoids, and classic immunosuppressants. The review will also cover current literature on the use of new biologic therapies in patients with HIV infection. Finally, we will discuss the risk of drug interactions during psoriasis treatment in these patients, who receive multiple pharmacologic therapies.
Key words:
psoriasis
HIV
drug interactions
biologic therapies
immunodeficiency
Resumen
La coexistencia de psoriasis con la infección por el virus de la inmunodeficiencia humana (VIH) implica dificultades diagnósticas y terapéuticas para el especialista en Dermatología.
En este artículo se revisan las peculiaridades de dicha coexistencia desde el punto de vista epidemiológico, patogénico, anatomopatológico, clínico y pronóstico. Se describen las principales dermatosis que se incluyen en el diagnóstico diferencial. También se analizan las diferentes posibilidades terapéuticas en estos pacientes, dependiendo del grado de inmunosupresión. Se incluyen como opción de tratamiento la terapia antirretroviral, el tratamiento tópico, los retinoides, los fármacos inmunosupresores clásicos y se revisa la literatura actual sobre el uso de las nuevas terapias biológicas en pacientes con infección por el VIH. Finalmente, se describe el riesgo de interacciones farmacológicas que tienen lugar en el tratamiento de la psoriasis en estos pacientes, que reciben múltiples fármacos.
Palabras clave:
psoriasis
VIH
interacciones farmacológicas
terapias biológicas
inmunosupresión
Full text is only aviable in PDF
References
[1.]
UNAIDS/WHO. ONUSIDA. Situación de la epidemia de SIDA: diciembre 2006. Published on the Internet: 21-11-2006. Accessed: 17 February 2008. Available at: http://data.unaids.org/pub/EpiReport/2006/2006_EpiUpdate_es.pdf
[2.]
M.L. Obuch, T.A. Maurer, B. Becker, T.G. Berger.
Psoriasis and human immunodeficiency virus infection.
J Am Acad Dermatol, 27 (1992), pp. 667-673
[3.]
L.U. Wölfer, N. Djemadji-Oudjiel, M. Hiletework.
HIV-assoziierte Psoriasis. Klinische und histologische Beobachtungen an 36 Patienten.
Hautarzt, 49 (1998), pp. 197-202
[4.]
M.A. Muñoz-Pérez, A. Rodríguez-Pichardo, F. Camacho, M.A. Colmenero.
Dermatological findings correlated with CD4 lymphocyte counts in a prospective 3 year study of 1,161 patients with human immunodeficiency virus disease predominantly acquired through intravenous drug abuse.
Brit J Dermatol, 139 (1998), pp. 33-39
[5.]
C. Ferrándiz, X. Bordas, V. García-Patos, S. Puig, R. Pujol, A. Smandia.
Prevalence of psoriasis in Spain. Epiderma project: phase I.
JEADV, 15 (2001), pp. 20-23
[6.]
B.K. Goh, R.K.W. Chan, P. Sen, C.T.S. Theng, H.H. Tan, Y.J. Wu, et al.
Spectrum of skin disorders in human immunodeficiency virus-infected patients in Singapore and the relationship to CD4 lymphocyte counts.
Int J Dermatol, 46 (2007), pp. 695-699
[7.]
N.M. Craven, C.W. Jackson, B. Kirby, C. Perrey, V. Pravica, I.V. Hutchinson, et al.
Cytokine gene polymorphisms in psoriasis.
Brit J Dermatol, 144 (2001), pp. 849-853
[8.]
G. Krueger, C.N. Ellis.
Psoriasis-recent advances in understanding its pathogenesis and treatment.
J Am Acad Dermatol, 5 (2005), pp. S94-S100
[9.]
W. Lew, A.M. Bowcock, J.G. Krueger.
Psoriasis vulgaris: cutaneous lymphoid tissue supports T-cell activation and «Type 1» inflammatory gene expression.
Trends Immunol, 25 (2004), pp. 295-305
[10.]
C. Ritchlin, S.A. Haas-Smith, D. Hicks, J. Cappuccio, C.K. Osterland, R.J. Looney.
Patterns of cytokine production in psoriatic synovium.
J Rheumatol, 25 (1998), pp. 1544-1552
[11.]
P. Ettehadi, M.W. Greaves, D. Wallach, D. Aderka, R.D. Camp.
Elevated tumor necrosis factor-alpha (TNF-alpha) biological activity in psoriatic lesions.
Clin Exp Immunol, 96 (1994), pp. 146-151
[12.]
L.H. Calabrese, N. Zein, D. Vassilopoulos.
Safety of antitumour necrosis factor (anti-TNF) therapy in patients with chronic viral infections: hepatitis C, hepatitis B and HIV infection.
Ann Rheum Dis, 63 (2004), pp. ii18-ii24
[13.]
B.J. Dezube, M.M. Lederman, B. Chapman, D.L. Georges, A.L. Dogon, P. Mudido, et al.
The effect of tenidap on cytokines, acute-phase proteins, and virus load in human immunodeficiency virus (HIV)-infected patients: correlation between plasma HIV-1 RNA and proinflammatory cytokine levels.
J Infect Dis, 176 (1997), pp. 807-810
[14.]
H. Valdez, M.M. Lederman.
Cytokines and cytokine therapies in HIV infection.
AIDS Clin Rev, (1997), pp. 187-228
[15.]
M.M. Reddy, S.J. Sorrell, M. Lange, M.H. Grieco.
Tumor necrosis factor and HIV P24 antigen levels in serum of HIV-infected populations.
J Acquir Immune Defic Syndr, 1 (1988), pp. 436-440
[16.]
C. Whalen, C.R. Horsburgh, D. Hom, C. Lahart, M. Simberkoff, J. Ellner.
Accelerated course of human immunodeficiency virus infection after tuberculosis.
Am J Respir Crit Care Med, 151 (1995), pp. 129-135
[17.]
J.B. Marriott, S. Cookson, E. Carlin, M. Youle, D.A. Hawkins, M. Nelson, et al.
A double-blind placebo-controlled phase II trial of thalidomide in asymptomatic HIV-positive patients: clinical tolerance and effect on activation markers and cytokines.
AIDS Res Hum Retroviruses, 13 (1997), pp. 1625-1631
[18.]
R.S. Wallis, P. Nsubuga, C. Whalen, R.D. Mugerwa, A. Okwera, D. Oette, et al.
Pentoxifylline therapy in human immunodeficiency virus-seropositive persons with tuberculosis: a randomised, controlled trial.
J Infect Dis, 174 (1996), pp. 727-733
[19.]
R.S. Wallis, P. Kyambadde, J.L. Johnson, L. Horter, R. Kittle, M. Pohle, et al.
A study of the safety, immunology, virology, and microbiology of adjunctive etanercept in HIV-1-associated tuberculosis.
AIDS, 18 (2004), pp. 257-264
[20.]
E. Mallon, D. Young, M. Bunce, F. Gotch, P.J. Easterbrook, R. Newson, et al.
HLA-Cw*0602 and HIV-associated psoriasis.
Brit J Dermatol, 139 (1998), pp. 527-533
[21.]
E. Mallon, M. Bunce, H. Savoie, A. Rowe, R. Newson, F. Gotch, et al.
HLA-C and guttate psoriasis.
Br J Dermatol, 143 (2000), pp. 1177-1182
[22.]
T.M. Johnson, M. Duvic, R.P. Rapini, A. Ríos.
AIDS exacerbates psoriasis.
N Engl J Med, 313 (1985), pp. 1415
[23.]
E. Mallon, C.B. Bunker.
HIV-associated psoriasis.
AIDS Patient Care STDs, 14 (2000), pp. 239-246
[24.]
J. García-Silva, J.A. Velasco-Benito, C. Peñabad, M. Armijo.
Psoriasis atípico revelador de infección por VIH.
Actas Dermosifiliogr, 85 (1994), pp. 145-149
[25.]
M.L. Cuéllar, L.R. Espinoza.
Rheumatic manifestations of HIV-AIDS.
Baillieres Best Pract Res Clin Rheumatol, 14 (2000), pp. 579-593
[26.]
R. Suárez-Fernández, F. Martín-Rodríguez, E. López-Bran, C. Núñez-Alonso, E. Sánchez-Yus, A. Robledo-Aguilar.
Psoriasis y SIDA.
Actas Dermosifiliogr, 85 (1994), pp. 633-636
[27.]
W. Louthrenoo.
Successful treatment of severe Reiter's syndrome associated with human immunodeficiency virus infection with etretinate: report of 2 cases.
J Rheumatol, 20 (1993), pp. 1243-1246
[29.]
E.S. Miralles, M. Núñez, M.E. De Las Heras, B. Pérez, R. Moreno, A. Ledo.
Pityriasis rubra pilaris and human immunodeficiency virus infection.
Br J Dermatol, 133 (1995), pp. 990-993
[30.]
N.S. Sadick, S. McNutt, M.H. Kaplan.
Papulosquamous dermatoses of AIDS.
J Am Acad Dermatol, 22 (1990), pp. 1270-1277
[31.]
G.K. Steigleder, H. Rasokat, U. Wemmer.
Psoriasis in immune deficiency related to HTLV III cellular immunity and immunohistochemical findings.
Z Hautkr, 61 (1986), pp. 1671-1678
[32.]
S. Ximana-Malagón, E. Chilenos, E. Jané.
Psoriasis, VIH y lesiones bucales asociadas.
Piel, 12 (1997), pp. 138-144
[33.]
B. Porras, M. Costner, A.E. Friedman-Kien, C.J. Cockerell.
Update on cutaneous manifestations of HIV infection.
Med Clin North Am, 82 (1998), pp. 1033-1080
[34.]
I. Mamkin, A. Mamkin, S. Ramanan.
HIV-associated psoriasis.
Lancet Infect Dis, 7 (2007), pp. 496
[35.]
T. Fischer, H. Schwörer, C. Vente, K. Reich, G. Ramadori.
Clinical improvement of HIV-associated psoriasis parallels a reduction of HIV viral load induced by effective retroviral therapy.
AIDS, 13 (1999), pp. 628-629
[36.]
V.L. De Socio, S. Simonetti, G. Stagni.
Clinical improvement of psoriasis in an AIDS patient effectively treated with combination antiretroviral therapy.
Scand J Infect Dis, 38 (2006), pp. 74-75
[37.]
U. Bartke, I. Venten, A. Kreuter, S. Gabbay, P. Altmeyer, N.H. Brockmeyer.
Human immunodeficiency virus-associated psoriasis and psoriatic arthritis treated with infliximab.
Brit J Dermatol, 150 (2004), pp. 784-786
[38.]
J.M. Casanova, M. Ribera.
Tratamiento tópico de la psoriasis.
Piel, 14 (1999), pp. 494-503
[39.]
Y. Kuwano, R. Watanabe, M. Fujimoto, M. Komine, A. Asahina, N. Tsukada, et al.
Treatment of HIV-associated eosinophilic pustular folliculitis with narrow-band UVB.
Int J Dermatol, 45 (2006), pp. 1265-1267
[40.]
J.M. Carrascosa.
Fototerapia y fotoquimioterapia.
Actas Dermosifiliogr, 95 (2004), pp. 259-284
[41.]
W.L. Morison.
PUVA therapy is preferable to UVB phototherapy in the management of HIV-associated dermatoses.
Photochem Photobiol, 64 (1996), pp. 267-268
[42.]
J. Breuer-McHam, G. Marshall, A. Adu-Oppong, M. Goller, S. Mays, T. Berger, et al.
Alterations in HIV expression in AIDS patients with psoriasis or pruritus treated with phototherapy.
J Am Acad Dermatol, 40 (1999), pp. 48-60
[43.]
L. Buccheri, B.R. Katchen, A.J. Karter, S.R. Cohen.
Acitretin therapy is effective for psoriasis associated with human immunodeficiency virus infection.
Arch Dermatol, 133 (1997), pp. 711-715
[44.]
A. Boada, M. Ribera.
Actualización en el uso del acitretino en la psoriasis.
Piel, 22 (2007), pp. 459-464
[45.]
J. Van Zander, S.J. Orlow.
Efficacy and safety of oral retinoids in psoriasis.
Expert Opin Drug Saf, 4 (2005), pp. 129-138
[46.]
B.S. Baker, C.E.M. Griffiths, S. Lambert, J.P. McFadden, H. Valdimarsson, L. Fry.
The effects of cyclosporin A on the lymphocyte and dendritic cell subpopulations in psoriasis.
Brit J Dermatol, 116 (1987), pp. 503-510
[47.]
R. Winchester, D.H. Bernstein, H.D. Fischer, R. Enlow, G. Solomon.
The cooccurrence of Reiter's syndrome and acquired immunodeficiency.
Ann Intern Med, 106 (1987), pp. 19-26
[48.]
T.A. Maurer, H.S. Zackheim, L. Tuffanelli, T.G. Berger.
The use of methotrexate for treatment of psoriasis in patients with HIV infection.
J Am Acad Dermatol, 31 (1994), pp. 372-375
[49.]
A. Kiryohara, K. Takamori, N. Nizuma, H. Ogawa.
Successful treatment of severe recurrent Reiter's syndrome with cyclosporine.
J Am Acad Dermatol, 36 (1997), pp. 482-483
[50.]
L.H. Calabrese, M.M. Lederman, J. Spritzler, R.W. Coombs, L. Fox, B. Schock, et al.
Placebo-controlled trial of cyclosporin-A in HIV-1 disease: implications for solid organ transplantation.
J Acquir Immune Defic Syndr, 29 (2002), pp. 356-362
[51.]
C. Argyropoulos, A. Mouzaki.
Immunosuppressive drugs in HIV disease.
Curr Top Med Chem, 6 (2006), pp. 1769-1789
[52.]
C. Masson, J.M. Chennebault, C. Leclech.
Is HIV infection contraindication to the use of methotrexate in psoriatic arthritis?.
J Rheumatol, 22 (1995), pp. 2191
[53.]
Cepeda JE, Williams FM, Ishimori ML, Weisman MH, Reveille JD. The use of anti-tumor necrosis factor therapy in HIV positive individuals with rheumatic disease. 2008;67:710-2.
[54.]
C.H. Smith, A.V. Anstey, J.N.W.N. Barker, A.D. Burden, R.J.G. Chalmers, D. Chandler, et al.
British Association of Dermatologists guidelines for use of biological interventions in psoriasis 2005.
Br J Dermatol, 153 (2005), pp. 486-497
[55.]
P.T. Ting, J.Y. Koo.
Use of etanercept in human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) patients.
Int J Dermatol, 45 (2006), pp. 689-692
[56.]
R.S. Wallis.
Reactivation of latent tuberculosis by TNF blockade: the role of interferon gamma.
J Investig Dermatol Symp Proc, 12 (2007), pp. 16-21
[57.]
J. Sellam, B. Bouvard, C. Masson, M. Rousière, C. Villoutreix, K. Lacombe, et al.
Use of infliximab to treat psoriatic arthritis in HIV-positive patients.
J Bone Spine, 74 (2007), pp. 197-200
[58.]
N. Gaylis.
Infliximab in the treatment of an HIV positive patient with Reiter's syndrome.
J Rheumatol, 30 (2003), pp. 407-411
[59.]
K. Wachi, T. Prasertsuntarasai, M. Kishimoto, K. Uramoto.
Tcell lymphopenia associated with infliximab and cyclophosphamide.
Am J Med Sci, 330 (2005), pp. 48-51
[60.]
N. Selenko-Gebauer, F. Karlhofer, G. Stingl.
Efalizumab in routine use: a clinical experience.
Br J Dermatol, 156 (2007), pp. 1-6
[61.]
A. Romero-Maté, C. García-Donoso, S. Córdoba-Guijarro.
Efficacy and safety of etanercept in psoriasis/psoriatic arthritis: an updated review.
Am J Clin Dermatol, 8 (2007), pp. 143-155
[62.]
M.A. Magliocco, A.B. Gottlieb.
Etanercept therapy for patients with psoriatic arthritis and concurrent hepatitis C virus infection: report of 3 cases.
J Am Acad Dermatol, 51 (2004), pp. 580-584
[63.]
N.N. Zein, Etanercept Study Group.
Etanercept as an adjuvant to interferon and ribavirin in treatment-naive patients with chronic hepatitis C virus infection: a phase 2 randomized, double-blind, placebo-controlled study.
J Hepatol, 42 (2005), pp. 315-322
[64.]
D.M. Aboulafia, D. Bundow, K. Wilske, U.I. Ochs.
Etanercept for the treatment of human immunodeficiency virus-associated psoriatic arthritis.
Mayo Clin Proc, 75 (2000), pp. 1093-1098
[65.]
G. Linardaki, O. Katsarou, P. Ioannidou, A. Karafoulidou, K. Boki.
Effective etanercept treatment for psoriatic arthritis complicating concomitant human immunodeficiency virus and hepatitis C virus infection.
J Rheumatol, 34 (2007), pp. 1353-1355
[66.]
P.P. Kaur, V.C. Chan, S.N. Berney.
Successful etanercept use in an HIV-positive patient with rheumatoid arthritis.
J Clin Rheumatol, 13 (2007), pp. 79-80
Copyright © 2008. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
