Erythema elevatum diutinum and AIDS: are they related?

Revenga, F; Vera, Ángel; Muñoz, Ángel Sánchez-Anguita; Llana, F García de la; Alejo, M.; Rodríguez-Peralto, J.L.

doi:10.1046/j.1365-2230.1997.1900625.x

Cited by 9 publications

(11 citation statements)

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“…Recurrent flares of EED were associated with episodes of pharyngitis and bronchitis, supporting this hypothesis . Physicians should have an awareness of the presence of EED in those infected with HIV, as it may be the first clinical sign of the disease . Additionally, lesions can easily be misdiagnosed as bacillary angiomatosis or KS, this supports the importance of histologic diagnosis for all of assumed KS in patients with HIV …”

Section: Eed and Associationsmentioning

confidence: 90%

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Erythema elevatum diutinum: a review of presentation and treatment

Momen

Jorizzo

Al‐Niaimi

2014

Acad Dermatol Venereol

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Erythema elevatum diutinum (EED) is a rare, chronic and treatable skin condition. It has many histological mimics and is often associated with a variety of underlying systemic diseases, when these are present the management and prognosis dictates the course of the EED. This review aims to highlight the differential diagnosis, clinical manifestations of EED and the possible underlying systemic disease. It is important for clinicians to be aware that EED may predate underlying conditions and the presence of lesions may indicate underlying disease activity. In some cases one may need 'search' for underlying disease. Treatment of these lesions is notoriously difficult. Dapsone is used as the mainstay of treatment, however other options exist. We have highlighted different treatment options and suggested a treatment algorithm. In some cases, treatment may need to be targeted at underlying disease.

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Section: Eed and Associationsmentioning

confidence: 90%

“…In nodular lesions, dapsone is often ineffective due to the fibrosis of lesions . Sixteen patients were reported to have nodular lesions; these were described in patients with underlying HIV ( n = 4) and IgA gammopathies ( n = 4) . Eleven patients were noted to have an extra‐cutaneous manifestations associated with EED.…”

Section: Treatment Of Eedmentioning

confidence: 99%

Erythema elevatum diutinum: a review of presentation and treatment

Momen

Jorizzo

Al‐Niaimi

2014

Acad Dermatol Venereol

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“…Only rare TEN cases have been treated with CSA in uncontrolled studies [84,85,86,87,88,89,90]. Beneficial effects were generally reported.…”

Section: Ten Treatmentsmentioning

confidence: 99%

Novel Treatments for Drug-Induced Toxic Epidermal Necrolysis (Lyell’s Syndrome)

Paquet

Pierard

Quatresooz³

2005

Int Arch Allergy Immunol

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Drug-induced toxic epidermal necrolysis (TEN) is a life-threatening disease characterized by extensive destruction of the epidermis. It apparently results from the formation of specific toxic drug metabolites by the keratinocytes. The mortality rate which averages 25–30% is mainly due to secondary septicemia, and to ionic and metabolic disturbances following loss of epidermal integrity. Apoptosis is the likely mechanism leading to massive keratinocyte death in TEN. Dysregulations in the tumor necrosis factor-α (TNF-α) pathway, CD95 system (Fas ligand, CD95L; Fas receptor, CD95R) and calcium homeostasis in the epidermis are involved in this apoptotic process. An active role has also been ascribed to T lymphocytes, macrophages and factor XIIIa-positive dermal dendrocytes. Despite progress, treatment of TEN remains controversial. In the past, systemic glucocorticoids were used in order to target the inflammatory reaction in TEN. However, there was no evidence for improvement of the healing process, while corticosteroids worsened the prognosis by increasing the risk of septicemia. Only a few cases have been treated with other drugs including cyclophosphamide, pentoxyfilline, thalidomide, anti-TNF-α antibodies and cyclosporin A. In the recent past, some TEN patients were treated with intravenous human immunoglobulins (IVIG). The rationale for such a treatment was to block the CD95 system on keratinocytes. The early promising clinical results of IVIG treatment in TEN were subsequently challenged. This review compares the effectiveness and drawbacks of the major drugs presently used in TEN treatment. Some future prospects in TEN management are also discussed.

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“…[13][14][15] There have also been reports of associations with rheumatic arthritis, 3,16,17 prostate carcinoma, 3,18 testicular lymphoma, 3 celiac disease, 19 Crohn's disease, 20 relapsing polychondritis 21 and, more recently, with HIV infection. [22][23][24][25] Among young males, exacerbated clinical states with nodular lesions seem to be correlated with HIV infection, in contrast with the clinical picture observed for the general population. 24,25 The EED skin lesions of this patient allowed the detection of HIV infection through laboratory investigation.…”

Section: Discussionmentioning

confidence: 89%

Erythema elevatum diutinum as a first clinical manifestation for diagnosing HIV infection: case history

et al. 2005

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CONTEXT: Erythema elevatum diutinum is a chronic and rare dermatosis that is considered to be a variant of leukocytoclastic vasculitis. It is probably mediated by immune complexes. It is generally associated with autoimmune, neoplastic and infectious processes. Recently, it has been added to the group of specific dermatoses that are associated with HIV. CASE REPORT: We report on the case of a patient who had erythema elevatum diutinum as the first clinical evidence for diagnosing HIV infection. Dapsone was used in the treatment of this patient, and partial regression of the lesions was achieved within 15 days, even before antiretroviral therapy was prescribed. CONCLUSION: When there is a diagnosis of erythema elevatum diutinum, HIV infection should be investigated, especially in atypical and exacerbated clinical manifestations.

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Erythema elevatum diutinum and AIDS: are they related?

Cited by 9 publications

References 0 publications

Erythema elevatum diutinum: a review of presentation and treatment

Erythema elevatum diutinum: a review of presentation and treatment

Novel Treatments for Drug-Induced Toxic Epidermal Necrolysis (Lyell’s Syndrome)

Erythema elevatum diutinum as a first clinical manifestation for diagnosing HIV infection: case history

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