Psoriasis may present for the first time at progression to AIDS. There are reports of improvement of psoriasis in the setting of immune reconstitution with ART, after initial flares.[148] HIV infection may alter the course of psoriasis in individual patients with some patients having co-existing patterns of psoriasis such as both guttate psoriasis and psoriasis vulgaris.[149] More extensive lesions with Increased presence of acral lesions and inverse psoriasis are more frequent.1 Severe exfoliative erythroderma may also /dermatological-conditions/references/occur.[151] Patients with HIV infection are more likely to have arthritis associated with psoriasis.[152]