Cutaneous Disease and Drug Reactions in HIV Infection

To the Editor: Coopman et al. (June 10 issue)¹ found that cutaneous diseases, including drug reactions, are extremely common in patients with human immunodeficiency virus (HIV) infection, and that their incidence increases as immune function deteriorates. They discussed ascertainment bias as a possible contributing factor to these associations, with cutaneous abnormalities possibly precipitating the discovery of HIV infection in some people. They did not mention the possibility of ascertainment bias in the reverse direction – i.e., the presence of HIV infection may have increased the likelihood that cutaneous disorders would come to medical attention. People with HIV infection see physicians…