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Immunologically Mediated Skin Diseases

Immunologically Mediated Skin Diseases

Kim B. Yancey

Thomas J. Lawley

A number of immunologically mediated skin diseases and immunologically mediated systemic disorders with cutaneous manifestations are now recognized as distinct entities with consistent clinical, histologic, and immunopathologic findings. Many of these disorders are due to autoimmune mechanisms. Clinically, they are characterized by morbidity (pain, pruritus, disfigurement) and in some instances by mortality (largely due to loss of epidermal barrier function and/or secondary infection). The major features of the more common immunologically mediated skin diseases are summarized in this chapter (Table1).

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Human immunodeficiency virus (HIV) infection

Human immunodeficiency virus (HIV) infection

HIV therapeutics is a specialised field so only those doctors with experience in HIV management should prescribe antiretroviral therapy.

Rather than acting as a detailed guide, this chapter aims to provide general information that will enable the practitioner or student to understand the principles of antiretroviral therapy, to recognise common adverse effects of the drugs, and to appreciate the importance of drug interactions with antiretrovirals. Prophylaxis and treatment of opportunistic infections in HIV-infected adults are also detailed.

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Human Papillomavirus Infections

Human Papillomavirus Infections

Richard C. Reichman

DEFINITION

Human papillomaviruses (HPVs) selectively infect the epithelium of skin and mucous membranes. These infections may be asymptomatic, produce warts, or be associated with a variety of both benign and malignant neoplasias.

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Hirsutism and Virilization

Hirsutism and Virilization

David A. Ehrmann

Hirsutism, defined as excessive male-pattern hair growth, affects approximately 10% of women. If often represents a variation of normal hair growth, but rarely it is a harbinger of a serious underlying condition. Hirsutism is often idiopathic but may be caused by conditions associated with androgen excess, such as polycystic ovarian syndrome (PCOS) or congenital adrenal hyperplasia (CAH) (Table 1). Cutaneous manifestations commonly associated with hirsutism include acne and male-pattern balding (androgenic alopecia). Virilization refers to the state in which androgen levels are sufficiently high to cause additional signs and symptoms such as deepening of the voice, breast atrophy, increased muscle bulk, clitoromegaly, and increased libido; virilization is an ominous sign that suggests the possibility of an ovarian or adrenal neoplasm.

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