Skin eruption in primary human immunodeficiency virus infection

Although primary HIV infection is symptomatic in 50-90% of cases, it may go unnoticed in most of them. The clinical manifestations as a whole are known as acute retroviral syndrome, which is related to the high rate of replication of the retrovirus and the immune system's strong response to it. The most frequent symptoms are fever, fatigue, skin eruption and generalized lymphadenopathies, which usually appear between the 2nd and 4th weeks of the infection. The eruption usually involves the face and upper third of the trunk, and shows orangish-erythematous macules and papules, rounded and non-confluent, some with central necrosis. On many occasions, it is accompanied by involvement of the mucous membranes. We describe four cases of primary HIV infection. The diagnosis in this stage of the disease is established by means of non-serological laboratory techniques (viral load, proviral DNA) and makes it possible to initiate early antiretroviral treatment.