Therapeutic challenges of psoriasis in the HIV‑infected patient: A case report

Arbune,Manuela; Arbune,Anca-Adriana; Niculet,Elena; Anghel,Lucretia; Fotea,Silvia; Tatu,Alin Laurentiu

doi:10.3892/etm.2021.11098

Therapeutic challenges of psoriasis in the HIV‑infected patient: A case report

Authors:
- Manuela Arbune
- Anca-Adriana Arbune
- Elena Niculet
- Lucretia Anghel
- Silvia Fotea
- Alin Laurentiu Tatu
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Affiliations: Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800010 Galati, Romania, Department of Neurology, ‘Fundeni’ Clinical Institute, 022328 Bucharest, Romania, Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800010 Galați, Romania
Published online on: December 28, 2021 https://doi.org/10.3892/etm.2021.11098
Article Number: 175
Copyright: © Arbune et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Psoriasis can be paradoxically associated with human immunodeficiency virus (HIV) infection, having a prevalence similar to the general population but with a more severe evolution. In the genetically predisposed patients with the CW^*0602 haplotype, HIV infection can be a triggering factor and a first sign of infection, and lesions can spontaneously remit with immune reconstruction after antiretroviral therapy. Our patient is a 34 year‑old male with recent HIV infection, in spite of being for over 10 years the partner of an HIV‑positive patient with whom the patient has two HIV‑positive children. The patient was diagnosed with psoriasis 7 years ago and was treated topically. The physical examination at HIV diagnosis was overall favorable, with skin findings compatible with disseminated vulgar psoriasis. Following antiretroviral treatment with Triumeq the patient had a favorable viral response, with complete viral suppression after 12 weeks, but the pre‑existent psoriasis lesions worsened. Methotrexate (MTX) treatment followed for 12 weeks, with partial improvement of psoriatic dermatitis. This medication was continued for 1 year, but the lesions reappeared, possibly due to treatment resistance. MTX treatment for psoriasis in the HIV‑infected patient was beneficial, but limited to one year, leaving biologics as possible treatment following therapy under strict monitoring for adverse effects, T‑lymphocyte CD4⁺ and viral levels.

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