Long-Lasting Seborrheic Dermatitis Associated With Human Immunodeficiency Virus

Human immunodeficiency virus (HIV) infection is transmitted primarily through sexual contact, blood exposure, or from mother to child. The virus targets CD4-positive T cells, progressively impairing immune function and potentially advancing to acquired immunodeficiency syndrome (AIDS) if left untreated. HIV infection is known to be associated with various cutaneous and mucocutaneous conditions, including seborrheic dermatitis, psoriasis, oral candidiasis, herpes zoster, and Kaposi's sarcoma. We report a case of a 44-year-old man in whom HIV infection was early diagnosed after a treatment-refractory seborrheic dermatitis. He had a six-month history of persistent facial erythema, lichenification, and scaling that were unresponsive to topical therapy. Laboratory tests revealed HIV infection, with a markedly reduced CD4-positive T cells and elevated HIV RNA copy levels at diagnosis. After initiating antiretroviral therapy (ART), the immune status and the cutaneous symptoms significantly improved. Seborrheic dermatitis is frequently observed in patients with HIV infection, particularly in those with profound CD4 T cell depletion. This case highlights the potential for resistant seborrheic dermatitis to be an initial manifestation of HIV infection and underscores the importance of early diagnosis and therapeutic intervention.