HIV-seropositive patients with opportunistic infections may have adrenocortical involvement by a variety of parasites,
which manifests signs and symptoms of Addison’s disease.Such patients undergo progressive hyperpigmentation of the skin, nails, and mucous membranes. In actuality, most HIV-seropositive patients presenting with diffuse multifocal macular brown pigmentations of the buccal mucosa show no features of adrenocortical disease. The oral pigmentation cannot be attributed to medications in this population because cases have been recorded in individuals who have not received any medications that could be so implicated. Thus, the etiology remains undetermined. As mentioned, the pigmentation resembles most of the other diffuse macular pigmentations discussed so far; the buccal mucosa is the most frequently affected site, but the gingiva, palate, and tongue may also be involved.
Like all diffuse melanoses, HIV-associated pigmentation is microscopically characterized by basilar melanin pigment, with incontinence into the underlying submucosa.
Like all diffuse melanoses, HIV-associated pigmentation is microscopically characterized by basilar melanin pigment, with incontinence into the underlying submucosa.