The first organ that may be affected in human immunodeficiency virus (HIV) infection is the skin. Before the advent of highly active antiretroviral therapy (HAART), the inevitable decrease in CD4 cells with disease progression was accompanied by a variety of HIV-associated skin diseases. HIV infection was often suspected initially based on the occurrence of cutaneous diseases, such as Kaposi sarcoma (KS) or extensive molluscum contagiosum, or in a patient with particularly severe or recalcitrant manifestations of a common skin disease, such as psoriasis.

With the use of HAART, the number and frequency of cutaneous manifestations have plummeted in the United States and other countries. Furthermore, in patients with advanced HIV infection, the cutaneous manifestations often remit spontaneously when HAART is started. Nonetheless, some patients have viral resistance to these drugs or personal or economic reasons for not taking HIV medications, and in this group, the severe cutaneous manifestations of advanced HIV infection may still be seen.

Acute HIV infection is characterized by a morbilliform rash resembling measles, fever, lymphadenopathy, sore throat, and malaise may accompany the eruption.

As the number of CD4 cells decreases to fewer than 200 during the course of infection, signaling the onset of acquired immunodeficiency syndrome (AIDS), skin manifestations become more severe and increase in number.