Prevalence of pruritic papular eruption among HIV patients: A cross-sectional study

Mohammed, S.Sheik; Vellaisamy, Seethalakshmi Ganga; Gopalan, Kannan; Sukumaran, Lekha; Valan, A S

doi:10.4103/ijstd.ijstd_69_18

Cited by 8 publications

(4 citation statements)

References 16 publications

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“…Papular pruritic eruption (PPE), which is the most prevalent dermatologic manifestation in HIV-infected patients, is characterized by chronic symmetric papular eruptions on the limbs, trunk, and sometimes face. The exact etiology of PPE is not yet identified, but it has been demonstrated that lower CD4 cell counts are correlated with more intense pruritus and increased rash severity [ 4 ].…”

Section: Resultsmentioning

confidence: 99%

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

Afshar

Goodarzi

Emadi

et al. 2023

International Journal of Microbiology

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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.

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Section: Resultsmentioning

confidence: 99%

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

Afshar

Goodarzi

Emadi

et al. 2023

International Journal of Microbiology

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“…Consequently, it enables the intensification of the itchy sensation on the skin (Chua et al 2014, Vijayan et al 2017. In a study conducted by Mohammed et al (2019), it was found that most of the subjects exhibited IL-5 expression (40% of the subjects) as opposed to IL-4 expression (10% of the subjects). The majority of the subjects also had elevated levels of eosinophils in both their blood and tissues.…”

Section: Discussionmentioning

confidence: 99%

“…The increase in serum IL-5 levels has been found to be proportional to the severity of the pruritic papular eruption. The mean serum IL-5 levels in HIV patients with a pruritic papular eruption have been observed to be higher compared to HIV patients without an eruption (Vijayan et al 2017, Mohammed et al 2019.…”

Section: Introductionmentioning

confidence: 95%

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

Ayu Wikan Sayekti,

Ann Kautsaria Putri,

Dwi Retno Adi Winarni

et al. 2024

FMI

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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.

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“…PPE is a unique dermatosis associated with advanced HIV infection and is characterized by sterile papules, nodules, or pustules with a hyperpigmented, urticarial appearance and pruritus. 30 The underlying etiology probably reflects a hypersensitivity reaction to insect bites in susceptible patients. 31 The prevalence rate of seborrheic dermatitis in patients with HIV ranges from 8% to 21% in India as reported by Chopra and Arora 16 and is only 1.15% in China as reported by Han et al 1 In the present study, two (5.0%) patients presented with paronychia, one (2.5%) with melanonychia, and one (2.5%) with nail dystrophy.…”

Section: Discussionmentioning

confidence: 99%

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

Mowla

Manchur

Islam

et al. 2022

Int J Dermatol Venereol

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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 <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.

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Prevalence of pruritic papular eruption among HIV patients: A cross-sectional study

Cited by 8 publications

References 16 publications

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

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

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

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

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