HIV disease, from discovery to management: the major role of the dermatologist.

The epidemic of AIDS is a terrible and unexpected scourge that strikes persons in the most productive years of their lives and seriously threatens to drain the resources of our health care system. It is also a real risk to health care personnel, who must remember and adhere to universal precautions against blood-borne disease to prevent accidental infection on the job. At the same time they must not in any way deny proper and compassionate care, which all patients deserve, whatever their HIV status. Dermatologists, in particular, must be alert to early signs (often cutaneous) of HIV infection, and must be careful to take precautions against infection because many dermatologic procedures expose them to risk. The hopeful news is that early diagnosis of HIV infection and effective therapy with Zidovudine and other agents may prevent development of symptomatic infection and prolong the lives of HIV-infected patients, perhaps indefinitely. In future, physicians must consider HIV disease a chronic problem to be treated with the same care and attention, in hopes of promoting long-term survival, as diabetes or heart disease.