[Question #10598] Psoriasis HIV risk

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21 months ago
Dear Doctors. I am sorry to have to insist on a subject that I asked about more than a year ago.
The problem is my psoriasis on my back and buttocks. I understand that the epidermis and dermis poriasis is infiltrated with lymphocytes that are targets for hiv. Since my last negative test for hiv, I have had 5 body to body massages in which some vaginal fluid may have been rubbed on my lesions. There has been absolutely no penetration, neither anal nor vaginal, only massage with the masseuse's body. The psoriasis lesions are mild, and are not open or ulcerated. 
15 days after having sex with my wife, she has started with diarrhea, which lasts for 15 days. She has no fever. 
This situation is causing me anxiety and I don't know if a test is indicated. 
Thank you for your patience and sorry for returning to a subject that has been discussed a long time ago. 
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Edward W. Hook M.D.
21 months ago
Welcome back to the Forum and thanks for your questions although I'm sorry you felt the need.  This question is basically a repeat of questions you asked of both Dr. Handsfield and me more than a year and 1/2 ago.  The answer has not changed.  There is no scientific data to suggest that the lesions of psoriasis represent an entrance way for HIV when infected genital secretions are rubbed on them.

Your wife's diarrhea is coincidental and unrelated to the body-to-body massages you mention.  I see no reason for concern and no need for testing.  EWH
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21 months ago
Thank you for your rapid answer.
My concern is because I have read that psoriatic lesions are infiltrated with cd4 lymphocytes, and that these are the target cells of hiv. 
In any case. Your answer reassures me. Maybe I should stay away from the internet....
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Edward W. Hook M.D.
21 months ago
You are absolutely right. The Internet is not your friend here. Much of the information there is taken out of context, misinterprets available data, is out of date, or is just plain wrong. Please don’t worry EWH---
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21 months ago
There is something in your words that scared me a bit. 
Is not the same thing “There is no scientific data to suggest that the lesions of psoriasis represent an entrance way for HIV”  than  “There is scientific data to suggest that the lesions of psoriasis do not represent an entrance way for HIV”. Could I be confident that psoriasis lesions are not an entrance way for HIV?
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Edward W. Hook M.D.
21 months ago
Sigh.  You seem to be looking for something to worry about.  Be confident that your psoriasis DOES NOT represent an increased risk for HIV acquistion.  Let me state it another way.  The CDC, the WHO, and virtually all experts agree that receipt of body to body massage, as well as masturbation are NO RISK sexual activities.   You've worried unnecessarily for years.  You need to address this- perhaps through counseling; I make this recommendation out of concern for you, nothing more.

As this is the 3rd response, this completes this thread.  There will be no more responses.  EWH
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