Pruritic papular eruption revealing HIV

Abstract

Pruritic papular eruption (PPE) described in HIV is a skin disease often encountered in HIV-positive patients. It is most often a sign of severe immunodeficiency and is commonly reported in African, Southeast Asian, and Indian populations [1,2]. It affects both adult females and males and may also be seen in children. The elementary lesion is a discrete, firm, erythematous, urticarial, very itchy papule of the extremities, face, and trunk, sparing the palms and soles. Painful excoriations in the genital mucosa are sometimes described. The CD4+ lymphocyte count (CD4) is usually below 250 cells/mm3. Histopathology reveals a lymphohistiocytic, inflammatory, perivascular, and periannexal infiltrate with a variable number of eosinophils. According to the World Health Organization (WHO), it is recommended to all HIV patients with antiretroviral therapy (ART), regardless of the staging and the CD4 count [3]. However, an elective treatment for PPE has not yet been found. Regression has been noted in some cases after the initiation of antiretroviral therapy. UVB therapy seems to be the most successful method in cases not improving with antiretroviral therapy [4]. Herein, we report the case of a patient who presented with PPE revealing HIV.