An important role in a number of different clinical manifestations of HIV infection is played by the pathology of the skin and mucous membranes. The authors demonstrate an interesting clinical case of the development of seborrheic dermatitis against the background of mixed infection (pneumocystis pneumonia and generalized cytomegalovirus infection) in a patient with HIV infection. The severity of the pathology determined the state close to «near miss», despite adequate etiopathogenetic and symptomatic therapy; progression of the underlying disease against the background of minimal skin syndrome was noted.
The described clinical case allows to look at this problem from a different angle and correctly draw up a modern psychological portrait of a dermatological patient with HIV infection. The following features of the patient’s psychological profile were noted: high readiness for risk, impulsiveness in decision making and actions, high level of sociability, positive self-feeling, high resistance to stress, ergopathic type of attitude towards the disease, coping strategies as dissimulation, optimism and distraction, which led to the formation of HIV- dissidence. The authors also discuss possible reasons for the probable development of the immune reconstitution inflammatory syn- drome (IRIS) in a young patient against the background of initiated intensive multicomponent antiretroviral therapy (ART). Currently, IRIS can be considered as a set of inflammatory diseases associated with a paradoxical exacerbation of pre-existing infectious processes after the start of ART.

Keywords: HIV-dissidence, psychological portrait of the patient, «near miss» state, seborrheic dermatitis, pneumocystis pneumonia, immune reconstitution inflammatory syndrome, HIV infection