A Review of Biologics and Other Treatment Modalities in HIV-Associated Psoriasis

Refractory psoriasis poses a significant challenge to dermatologists, and comorbid conditions may further exacerbate that challenge. This is especially true for conditions that compromise a patient’s immune status—such as human immunodeficiency virus (HIV)—as many of the most potent medications in the psoriasis armamentarium rely on immunomodulation. Moreover, patients with HIV are often excluded from clinical trials because of their immunocompromised state. Therefore, most treatment recommendations rely on anecdotal evidence derived from case reports and case series. This article reviews the current recommendations regarding management of HIV-associated psoriasis, with a particular focus on the relatively recent use of biologic agents in this population. Though there is a risk of compounding patients’ suppressed immune status, the reports to date have demonstrated promise in treating refractory HIV-associated psoriatic disease, and these agents may play a role in managing appropriately selected patients.