Pruritic Papular Eruption Research Articles

The effectiveness of ceramide moisturizing cream in pruritic papular eruption treatment of HIV/AIDS patients

Background: Pruritic papular eruption (PPE) is one of the most common skin manifestations in HIV/AIDS patients. Pruritic papular eruptions are due to immune dysregulation, causing dominance of interleukin-4, which causes a decrease in ceramide synthesis (CER) and impaired skin barrier function. This study aimed to investigate the effectiveness of CER over non-CER moisturizing cream in HIV/AIDS patients with PPE. Methods: Double-blind experimental design. The research subjects are PPE patients at Dr. Sardjito General Hospital. CER and non-CER moisturizing cream are applied for three weeks, respectively. Analysis of the trans-epidermal water loss (TEWL), skin hydration, and itching were analyzed using an unpaired T-test or the Mann-Whitney test with a significance of p<0.05. Results: Ceramide synthesis moisturizing cream decreased the TEWL value by 3.56 ± 2.38 g/m2/hour; increased the value of skin hydration by 16.39±7.19 a.u.; decreased skin lesions by 0.79 ± 4.95; reduced itching by 1.54 ± 0.78 and without causing side effects. Non-CER moisturizing cream decreased the TEWL value by 1.57 ± 2.00 g/m2/hour; increased the value of skin hydration by 12.03 ± 6.88 a.u.; decreased skin lesions by 1.42 ± 3.00; reduced itching by 1.17 ± 0.70 and also without causing side effects. Conclusion: Ceramide cream is more effective than non-CER moisturizing cream in reducing TEWL and increasing skin hydration. Ceramide and non-CER moisturizing creams have the same effectiveness in reducing the number of lesions and reducing itching. Ceramide and non-CER moisturizing creams do not cause side effects.

Expressions of Interleukin-4 and Interleukin-5 in Nodular Prurigo and Pruritic Papular Lesions

Highlights:1. An examination of IL-4 and IL-5 expressions in nodular prurigo and pruritic papular eruption is crucial for enhancing the effectiveness of biological agent therapy, specifically for HIV/AIDS patients.2. The findings offer evidence suggesting the possibility of IL-4 as a treatment target for individuals diagnosed with nodular prurigo, as well as IL-4 and IL-5 for those diagnosed with pruritic papular eruption. AbstractPruritic papular eruption is a dermatosis characterized by pruritic symptoms in patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Similarly, nodular prurigo is an itchy dermatosis with lesions and histopathological features that resemble those of pruritic papular eruption. Both conditions share a common etiopathogenesis, which involves the cytokines produced by T helper 2 (Th2) cells. Nodular prurigo and pruritic papular eruption are chronic and frequently recalcitrant, thus posing challenges in treatment. The use of biological agents represents a treatment development for chronic and recalcitrant dermatoses. This study aimed to determine the difference in the mean percentage of interleukin-4 (IL-4) and interleukin-5 (IL-5) expressions between nodular prurigo and pruritic papular eruption lesions, which may establish a basis for further biological agent therapy. A cross-sectional study was conducted using paraffin block preparations of the skin lesions of patients diagnosed with nodular prurigo (n=16) and pruritic papular eruption (n=16). Each paraffin block preparation involved immunohistochemical staining using IL-4 and IL-5 monoclonal antibodies. The expressions of IL-4 and IL-5 were assessed through ImageJ for Windows, version 1.53 (National Institutes of Health and the Laboratory for Optical and Computational Instrumentation, University of Wisconsin, USA) by pathologists. The data were analyzed using an unpaired t-test with a significance level of p<0.05. The analytical results indicated that data on the average age of the two groups, disease duration, and storage sample duration followed a normal distribution (p>0.05). The mean percentage of IL-4 expression was significantly different between the nodular prurigo and pruritic papular eruption groups (p=0.000). However, the mean percentage of IL-5 expression was not significantly different between the two groups (p=0.060). In conclusion, the expression of IL-4 was higher in the nodular prurigo group in comparison to the pruritic papular eruption group. Nonetheless, the expression of IL-5 was comparably high in both the nodular prurigo and pruritic papular eruption groups.

Dermatological manifestations of HIV: Implications for esthetic and clinical management

ABSTRACT HIV/acquired immunodeficiency syndrome has significant systemic implications, with dermatological manifestations often being the earliest and most visible indicators of infection. These skin conditions can severely impact patients’ quality of life and esthetic health. This review explores a broad range of dermatological changes associated with HIV, including HIV-specific dermatoses such as papular pruritic eruption, xerosis, eosinophilic folliculitis, prurigo nodularis, and papular mucinosis. It also covers common dermatoses such as seborrheic dermatitis, psoriasis, pityriasis rubra pilaris, and hidradenitis suppurativa. In addition, the review examines skin infections (fungal, bacterial, and viral), HIV-related malignancies (Kaposi’s sarcoma and cutaneous lymphomas), and antiretroviral therapy (ART)-related skin changes including exanthematous reactions and lipodystrophy. Special attention is given to the management of these conditions, which often involves a combination of topical and systemic treatments along with ART. The phenomenon of immune reconstitution inflammatory syndrome and its dermatological manifestations are also discussed, highlighting the complexities of managing skin reactions as the immune system recovers. Furthermore, the review addresses ectoparasitic infestations and skin complications arising from intravenous drug use, which are prevalent in HIV patients. Effective management of these dermatological issues is crucial not only for improving physical health but also for addressing the profound esthetic concerns that affect patients’ psychological well-being. Early recognition and appropriate treatment strategies can lead to better patient outcomes and enhanced quality of life. Advances in ART and dermatological therapies continue to improve the care provided to HIV patients, ensuring a comprehensive approach that considers both medical and esthetic aspects of their health. This review underscores the importance of a multidisciplinary approach in managing the diverse and complex skin conditions associated with HIV.

HIV: Inflammatory dermatoses

Patients living with HIV may experience a variety of inflammatory dermatoses, ranging from exacerbations of underlying conditions to those triggered by HIV infection itself. This article presents a current literature review on the etiology, diagnosis and management of atopic dermatitis, psoriasis, pityriasis rubra pilaris, lichen planus, seborrheic dermatitis, eosinophilic folliculitis, pruritic papular eruption and pruritus, in patients living with HIV.

Mupirocin–Induced Allergic Contact Dermatitis: A Case Report and a Review of the Literature

Background: Mupirocin, an antibiotic, is frequently used to treat special traumatic infected skin lesions, such as impetigo, methicillin-resistant Staphylococcus aureus (MRSA), burn, scratch after operation, etc. Topical use of mupirocin can lead to some adverse drug reactions (ADR). Objectives: To report a case of mupirocin-induced contact dermatitis and a review of the literature to identify the causative factors and clinical characteristics. Methods: We report a case of contact dermatitis in a 39-year-old woman which happened 2 days after mupirocin ointment application on her hand. Also, a review of the literature was done according to PRISMA guidelines. PubMed, Scopus, Web of Science, and Google Scholar were searched. Time or language filters were not used and all related reports were included. Results: In the mentioned case, mupirocin has a causative role in dermatitis. The review showed 10 cases of mupirocin-induced allergy. The clinical presentations included serum sickness, diffuse urticaria, fever, arthralgias, toxic epidermal necrolysis, pruritus, rash, breathlessness, palpitations, flushing, redness all over the body, low blood pressure, severe allergic contact dermatitis, pruritic papular eruption, extensive contact dermatitis, allergic contact hypersensitivities. All cases were improved after anti-allergic treatments except one who had been tracheostomy and was in serious condition. Conclusions: this is the first review of mupirocin-induced allergy. Although these incidences are rare, clinicians should be aware to prevent severe reactions with serious consequences.

A Comprehensive Review on HIV-Associated Dermatologic Manifestations: From Epidemiology to Clinical Management.

Dermatological disorders are among the most prevalent manifestations of HIV infection/acquired immunodeficiency syndrome (AIDS). In this review, we aimed to characterize the various dermatologic presentations among HIV-infected patients with a detailed categorization of the mucocutaneous signs and symptoms, their etiopathogenic factors, and clinical management. In fact, cutaneous manifestations of HIV are quite various, ranging from AIDS-specific skin eruptions (xerosis, pruritic papular eruptions, eosinophilic folliculitis, and acne), opportunistic infections (herpes simplex, molluscum contagiosum, cutaneous leishmaniasis, bacillary angiomatosis, disseminated histoplasmosis, disseminated cryptococcosis, and zoster) to AIDS-related malignancies (Kaposi's sarcoma, lymphoma, and nonmelanoma skin cancers) and antiretroviral therapy (ART)-associated drug eruptions. We tried to classify HIV-related cutaneous presentations which can help clinicians for a better understanding of the various specific and nonspecific features of AIDS-associated cutaneous manifestations and management of the condition.

Association of dermatological manifestations with CD4 count among people living with HIV attending tertiary care hospital of South Gujarat.

Dermatological manifestations are common manifestations of human immunodeficiency virus (HIV) disease, seen in 80% to 95% of HIV-infected patients. Dermatological manifestations are considered clinical indicators to predict and assess the underlying immune status. This study aims to document the dermatological manifestations in relation to CD4 count in people living with HIV (PLHIV). Cross-sectional study in 250 PLHIV fulfilling inclusion-exclusion criteria was conducted. Variables including sociodemographic profile, recent CD4 count (data from antiretroviral therapy center), and dermatological manifestation (physical examination) were collected. Clinical diagnosis was established, and patients were grouped according to the World Health Organization immunological staging. Majority of PLHIV (39.6%) were in the age group of 31-40 years. Males were affected more than females (1.6:1). A total of 364 dermatoses were observed; dermatological manifestation per patient ranged from 1 to 4. 32.80%. PLHIV had CD4 count >500 cells/mm3, 15.60% had CD4 count between 200-349 cells/mm3. Majority of dermatosis had infectious etiology (77.6%), out of which dermatophytosis (27.2%) was the most common infectious condition, whereas pruritic papular eruption was the most common (11.6%) noninfectious condition. A statistically significant association of CD4 count was found with dermatophytosis (P ≤ 0.001) and candidiasis (P = 0.001). The study showed a significant association between the number of dermatological manifestation and CD4 count as majority of study participants (67.2%) had CD4 <500 cells/mm3 at the time of episode of dermatosis.

Pruritic papular eruption revealing HIV

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.

Shiitake Flagellate Dermatitis

A man in his early 70s presented with a 3-day history of intensely pruritic erythematous papules and papular vesicular eruption arranged in a flagellate pattern on his neck, trunk, (Figure 1), and extremities with no general symptoms. On questioning, he had eaten undercooked shiitake mushrooms 2 days before the onset of the cutaneous lesions. Laboratory investigation was unremarkable. A skin biopsy revealed spongiosis, marked papillary dermal edema, and a dermal perivascular inflammatory infiltrate mainly composed of lymphocytes and eosinophils.

Plasmacytoid Dendritic Cell Dermatosis Associated to Myeloproliferative/Myelodysplastic Neoplasms.

Cutaneous lesions in the setting of myeloproliferative neoplasms and myelodysplastic syndromes are poorly understood. We report 6 patients with pruritic papular eruptions composed of mature T-lymphocytes with large clusters of CD123-positive cells. Double immunohistochemical studies demonstrated a lack of myeloid cell nuclear differentiation antigen in the CD123-positive cells, which expressed SPIB, confirming that they were mature plasmacytoid dendritic cells. Four patients were diagnosed with chronic myelomonocytic leukemia and 2 with myelodysplastic syndromes (AREB-I and myelodysplastic syndromes with 5q deletion, respectively). All patients had a long history of hematological alterations, mainly thrombocytopenia, preceding the cutaneous disorder. Nevertheless, the skin lesions developed in all cases coincidentally with either progression or full-establishment of their hematological disease. Most cutaneous lesions disappeared spontaneously or after corticosteroid treatment. Molecular studies performed in both bone marrow and cutaneous lesions in 2 patients demonstrated the same mutational profile, confirming the specific, neoplastic nature of these mature plasmacytoid dendritic cells-composed cutaneous lesions.

Adverse cutaneous reactions after mRNA SARS-CoV-2 vaccination in 3 patients: a spectrum of severity.

KEY POINTSA healthy 7-year-old girl received her first dose of Pfizer-BioNTech BNT162b2 SARS-CoV-2 vaccine in her upper arm. Forty-eight hours later, she developed localized erythema, induration and pruritic papular eruption at the injection site ([Figure 1][1]). There were no mucosal lesions, joint

Predictors of Mucocutaneous Disorders in HIV-infected Children in Port Harcourt, Southern Nigeria

Background: Unindentified and untreated mucocutaneous disorders can lead to adverse consequences among HIV-infected children. These include physical discomfort, disfigurement , loss of school attendance, social stigma , low self esteem and depression&#x0D; Aim: To determine the predictors of mucocutaneous disorders in HIV-infected children receiving care in two tertiary hospitals in Port Harcourt, Southern Nigeria.&#x0D; Place and Duration of Study: the study was conducted over a six month period at the Pediatric infectious diseases clinic of the University of Port Harcourt Teaching Hospital (UPTH) and Rivers State University Teaching Hospital (RSUTH) Port Harcourt.&#x0D; Materials and Methods: It was a cross sectional study involving 372 HIV-infected children. Study participants were recruited by simple random sampling. Diagnosis of mucocutaneous disorders was based on clinical findings and relevant laboratory investigations.&#x0D; Results: The prevalence of mucocutaneous disorders in the study subjects was 30.1% with Pruritic Papular Eruptions as the most occurring lesion. Factors predictive of the occurrence of mucocutaneous disorders in HIV-Infected-subjects included: low socio-economic status (p-value=0.048;AOR=1.81, 95% CI=1.01-3.24), sub-optimal adherence to HAART (p-value=0.008; AOR=2.72,95% CI=1.29-5.73), WHO clinical stages 3 and 4 (p-value=0.043;AOR=2.48,95% CI=1.03-5.97) and non viral suppression (p-value=0.0001; AOR=15.78, 95% CI=8.52-29.25).&#x0D; Conclusion: The presence of these factors in a HIV-infected child indicates a need for prompt evaluation for mucocutaneous lesions so as to limit morbidity and mortality from these disorders.

Spinulosis revealing dermatomyositis relapse: A new description of Wong’s dermatomyositis

Sir, Dermatomyositis (DM) is a systemic autoimmune disease affecting characteristically the skin and muscles. The typical cutaneous features include Gottron’s papules, a heliotrope rash, and edema of the eyelids. Spinulosis is an unusual sign, not raising suspicion for a DM diagnosis. Herein, we report a case of DM relapsing as Wong’s dermatomyositis (WDM) as an isolated spinulosic eruption. A 42-year-old female presented with a pruritic papular eruption involving both arms and the back persistent for the last two months. An anamnesis included a history of DM diagnosed five years earlier, in complete remission under the administration of corticosteroids for three years. A physical examination revealed erythematous and violaceous scaly plaques resulting from confluent follicular papules, resembling pityriasis rubra pilaris (PRP) on the lateral sides of the arms (Fig. 1) and the upper back (Fig. 2). Muscular testing was subnormal and the general status was conserved. Laboratory findings revealed a high level of blood CPK (3×N), LDH (4×N), and ASAT (3.5×N), while electromyography displayed myogenic changes. A muscular biopsy revealed necrotic muscular cells with perifascicular atrophy and lymphocytic inflammatory infiltrate. A histological skin examination found follicular hyperkeratosis with perifollicular interface dermatitis and interstitial mucin deposits in the dermis (Fig. 3). Based on these findings, the diagnosis of WDM was retained. A malignancy workup was negative. Corticosteroid therapy was initiated with prednisone 1 mg/kg/day in combination with hydroxychloroquine 200 mg twice a day, resulting in a remarkable clinical and biological improvement.WDM is characterized by the presence of PRP-like follicular papules in a patient with dermatomyositis (DM) [1]. Some authors suggest that this exceptional presentation should be considered a true association of DM with PRP rather than a variant of DM [2]. In this rare form, spinulosic lesions are mainly located on the trunk or limbs with occasional palmoplantar keratoderma [2]. Follicular lesions are usually associated with the typical signs of DM but some cases of isolated PRP features related to WDM have been reported [3]. To our knowledge, none has been reported as a relapse of a previous classic DM. Our patient relapsed showing spinulosic lesions absent in the prior episode five years earlier, not displaying at this time any classic cutaneous signs of DM. Such puzzling presentations are very unusual and may be confusing for physicians. In our patient, the diagnosis was retained on the basis of the histopathological findings of interface dermatitis and interstitial mucin deposits in the dermis, increased serum levels of muscle enzymes with a myogenic electromyographic pattern, the typical muscular histological changes, and a medical history of DM diagnosed five years earlier. In WDM, histology usually reveals follicular hyperkeratosis with keratotic plugs filling dilated follicular infundibula, which may raise several differential diagnoses, including PRP, discoid lupus erythematosus (DLE), and, to a lesser degree, follicular psoriasis and keratosis pilaris [4]. Interface dermatitis and mucin deposits, as in our patient, are the hallmarks of distinguishing DM from PRP, follicular psoriasis, and keratosis pilaris. Although these findings may also be observed in DLE [4], in our patient, there were no clinical or histological arguments supporting DLE rather than a diagnosis of DM. Myositis as, well as interstitial lung disease, appears to be comparable to the classic variant [5]. The risk of associated internal malignancy is unknown but could be lower than in the classic form [4]. Treatment and management do not differ from classic dermatomyositis.

Cutaneous Manifestations of HIV/AIDS in the Era of Highly Active Antiretroviral Therapy: Evidence from Bangladesh

Abstract Objective: Skin diseases are common and striking features of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and may vary considerably by ethnic and geographic regions and by the influence of highly active antiretroviral therapy (HAART). However, little information exists regarding the cutaneous manifestations of patients with HIV/AIDS in Bangladesh. This study was performed to elucidate the spectrum of cutaneous disorders in patients with HIV/AIDS in the era of HAART. Materials: This descriptive cross-sectional study was carried out in Chittagong Medical College Hospital, Bangladesh from January 2017 and December 2020. Diagnosed case of HIV/AIDS for HAART therapy and all cases of HIV/AIDS who are already on HAART therapy were included in this study. Descriptive statistical analysis was carried out by using frequencies and percentages. Results: Of 40 patients with HIV/AIDS, 22 (55.0%) were male and 18 (45.0%) were female. The patients ranged in age from 8 to 60years, with a mean age of 38 ± 0.966years. Among all age groups, the highest 19 (47.5%) patients were in the 31- to 40-year age group. Most of the patients were migrant workers [22/40 (55.0%)] with low socioeconomic status [32/40 (80.0%)], and the most common transmission mode was heterosexual activity [36/40 (90.0%)]. Most of the patients [32/40 (80.0%)] had mucocutaneous disorders, 30/40 (75.0%) had infective dermatoses, and 21/40 (52.5%) had non-infective inflammatory dermatoses. Eight of forty (20.0%) patients presented with three or more skin disorders. The most common infective dermatoses were fungal infections [15/40 (37.5%)], followed by viral infections [8/40 (20.0%)], bacterial infections [4/40 (10.0%)], and scabies [3/40 (7.5%)]. The most common noninfective dermatosis was generalized pruritus [6/40 (15.0%)], followed by prurigo simplex [4/40 (10.0%)], psoriasis [4/40 (10.0%)], eczema [3/40 (7.5%)], pruritic papular eruption [1/40 (2.5%)], seborrheic dermatitis [1/40 (2.5%)], urticaria [1/40 (2.5%)], and xerosis [1/40 (2.5%)]. Patients treated with HAART had decreased rates of oral candidiasis and herpes simplex but increased rates of drug reactions [19/40 (47.5%)]. The most common drug eruption following HAART was a morbilliform rash [11/40 (27.5%)], and the most common offending agent was nevirapine. The prevalence of mucocutaneous disorders was higher in patients with a CD4 cell count of &lt;200cells/mm3. Conclusions: A wide range of mucocutaneous disorders is observed in Bangladeshi patients with HIV/AIDS, and HAART has an impact on the spectrum of HIV/AIDS-associated mucocutaneous disorders. Skin and mucocutaneous disorders are seen at every stage of HIV/AIDS and are the initial presentation in most patients in Bangladesh. There is a need for increased attention to the diagnosis and treatment of skin diseases affecting the quality of life of patients with HIV/AIDS.

Dermatological Manifestations of HIV/AIDS Patients in the Era of HAART: Report from an ART Center of Chattogram

Introduction: Skin diseases are common striking features of HIV/AIDS patients and may vary considerably due to ethnic and geographic regions and currently by the influence of HAART also. However, there is a dearth of information in Bangladeshregarding the dermatological manifestations in HIV/AIDS patients. The purpose of this study is to find out the spectrum of cutaneous disorders in HIV/AIDS patients in the era of HAART. Materials and Methods: A descriptive cross-sectional study has been carried out to find the targeted results in the Chittagong Medical College Hospital, Bangladesh between the periods 2017 and 2020. Results: Of the 40 patients with HIV/AIDS, 22 (55%) were males and 18 (45%) were females. The age of the patients ranged from 8 to 60 years with mean age 38 (±0.966 SD) years. The age-specific cumulative HIV/AIDS cases at 31-40 years were high 19 (47.5%) among all age groups. The majority of the patients were migrant worker 22 (55%) with low socio-economic 32 (80%) background and common transmission mode was heterosexual 36 (90%). Most of the patients 32 (80%) had mucocutaneous disorders and Infective dermatoses accounted 30 (75%) and the non-infective inflammatory dermatoses were 21 (52.5%). Eight (20%) patients presented with 3 or more skin disorders. Common infective dermatoses were fungal infections 15 (37.5%) followed by viral infections 8 (20%), bacterial infections 4 (10%) and scabies 3 (7.5%). Common non-infective dermatoses were generalized pruritus 6 (15%) followed by prurigo simplex 4 (10%), psoriasis 4 (10%), eczema 3 (7.5%), pruritic papular eruption 1 (2.5%), seborrhoeic dermatitis 1 (2.5%), urticaria 1 (2.5%) and xerosis 1 (2.5%).Patients treated with HAART had decreased rates of oral candidiasis, herpes simplex, but increased rates of drug reactions 19 (47.5%). The most common drug eruption following HAART is morbiliform rash 11 (27.5%) and the commonest offending agent is nevirapine. The prevalence of mucocutaneous disorders were higher in patients with CD4 &lt;200 cells/mm3. Conclusions: A wide range of skin disorders (80%) is observed in Bangladeshi HIV/AIDS patients and HAART had an impact on the spectrum of HIV/AIDS associated mucocutaneous disorders. They are seen at every stage of HIV/AIDS and are often the initial presentation in most instances within our environment. There is a need for increased attention to the diagnosis and treatment of skin diseases affecting the quality of life of HIV/AIDS patients.

Mucocutaneous Manifestations in HIV/AIDS Patients

Background: The main target of human immunodeficiency virus (HIV) is cluster of differentiation 4 (CD4) T lymphocytes and several other immune cells that have CD4 receptors. They are also present in skin and mucosa, such as Langerhans cells (LC). Mucocutaneous lesions are one of the first clinical presentations of immunosuppression in HIV seropositive patients that manifest at different stages of the infection and require early diagnosis and prompt treatment. Purpose: To determine the clinical characteristics and the pattern of various mucocutaneous manifestations in Human immunodeficiency virus/Acquired immune deficiency syndrome (HIV/AIDS) patients at Intermediate Care and Infectious Diseases Dr. Soetomo General Academic Hospital Surabaya. Methods: This is a descriptive retrospective study with a cross-sectional design. The study subject was classified as all HIV-AIDS patients with mucocutaneous manifestations treated in Intermediate Care and Infectious Diseases Dr. Soetomo General Academic Hospital Surabaya in 2019. Result: Out of the 614 patients who participated in the study, 72.1% were males. The majority of patients were in the age group 25–49 years (75.4%). The most common risk factor was heterosexuality (41.7%). Based on the distribution of mucocutaneous manifestations, the most common mucocutaneous manifestation was candidiasis mucocutan 387 patients (49.4%) followed by the pruritic papular eruption (PPE) 118 patients (15.1%) and human papillomavirus infection 57 patients (7.3%). Conclusion: Mucocutaneous manifestations occur throughout the course of HIV infection, and they can be considered as good clinical indicators for the progression of the disease and underlying immune status in resource-poor settings.

Gianotti-Crosti syndrome-like reaction to molluscum contagiosum-Clinical characteristics and response to treatment.

SummaryBackground and objectivesMolluscum contagiosum (MC) is a common viral infection. Hypersensitivity reactions reminiscent of Gianotti‐Crosti syndrome, termed Gianotti‐Crosti syndrome‐like reaction (GCLR), have been reported in a subset of patients. We report a series of patients with GCLR, better delineating its clinical presentation and course.Patients and methodsRetrospective chart review of all children presenting with GCLR at our Pediatric Skin Center between 2015 and 2020.Results26 children (14 boys) with a median age of 6.5 (3–11.3) years were included. GCLR involved the extensor surfaces of the extremities in all patients. More widespread eruptions also affected the trunk and face in 7 (27 %) and 6 (23 %) children respectively. Involvement of the skin overlying the Achilles tendons was a new finding in 4 (15 %) children. Itch was the predominant symptom in 20 (77 %) patients. The rash responded to topical and/or systemic corticosteroids and resolved within four weeks. GCLR was followed by clearance of MC in all patients within 9 (4–24) weeks.ConclusionsGCLR is a characteristic acute, wide‐spread, pruritic papular eruption, which often leads to emergency consultations and anxiety in affected patients. GCLR responds well to corticosteroid treatment, has a benign course, and heralds the healing of MC.

Disseminate and Recurrent Infundibulofolliculitis: An Under-Recognized Yet Treatable Entity.

Disseminate and recurrent infundibulofolliculitis (DRIF) is a pruritic papular eruption that predominantly affects young adults with Fitzpatrick skin types 4-6. Due to DRIF&rsquo;s rarity and under-recognition, no standardized treatment guidelines exist. However, several oral agents have been used, including vitamin A, antibiotics, and retinoids. Topical agents, such as calcineurin inhibitors and mid-potency steroids, can also be efficacious. This brief communication summarizes treatments for DRIF in the published literature. J Drugs Dermatol. 2021;20(12):1353-1354. doi:10.36849/JDD.6173.

Change in profile of cutaneous manifestations of HIV after the advent of antiretroviral therapy: a retrospective analysis

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;To date, there has been no study conducted in Zambia to determine the prevalence of mucocutaneous conditions among HIV positive patients on antiretroviral therapy.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The aim of the study was to determine the differences in cutaneous manifestations of HIV between HIV positive adult patients on antiretroviral therapy and antiretroviral naïve patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 143 adult HIV/AIDS patients with dermatological manifestations, and fulfilling inclusion criteria, were included. Among the 58 patients on antiretroviral therapy, the most common dermatoses were hyper-pigmentation (18.97%), fungal dermatitis (17.24%) genital herpes (8.62%), papular pruritic eruption (8.62%), oral candidiasis (8.62%) and Kaposi’s sarcoma (6.9%). The most common dermatoses among the 85 antiretroviral naive patients were oral candidiasis (34.12%), herpes Zoster (17.65%), hyper pigmentation (8.24%), eosinophillic folliculitis (7.06%), abscesses (5.88%), herpes labialis (4.71%) and Kaposi's sarcoma (4.71%). Among patients in Stage III of HIV infection, the proportion of patients with infectious dermatoses was significantly greater than the proportion of patients with non-infectious dermatoses (47.5% versus 28.6%; p=0.036).The odds of having an infectious dermatosis were 28% lower for patients on antiretroviral therapy as compared to antiretroviral naive patients (p=0.001).&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;There is a changing profile of muco-cutaneous conditions in HIV infected patients. Infectious dermatoses such as oral candidiasis and Herpes Zoster infections occur more frequently in antiretroviral naïve patients, as compared to patients on ART. Prevention of infectious dermatological conditions occurs with the use of ART.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;

Celiac Disease.

Celiac Disease.