Cytokines in the pruritic papular eruption of HIV

Abstract

The lower levels of IL-2 and gamma-IFN and the negative correlation between gamma-IFN and peripheral CD4+ lymphocytes may indicate an early phase of immunosuppression in PPE.

Pruritic papular eruption and eosinophilic folliculitis associated with human immunodeficiency virus (HIV) infection: A histopathological and immunohistochemical comparative study

“…[2][3][4][5][6] The laboratory findings also included high levels of blood IgE and eosinophilia. 13,22 The present study did not demonstrate any epidemiological or clinical difference between the HIV-PPE and HIV-EF groups except for the bodily distribution of cutaneous lesions, although the sites of the lesions were the clinical criteria for diagnosis. Both diseases affected young male patients who were determined to be HIV positive approximately 3 years previously and presented a 3-to 5-month period of disease onset (see Table I).…”

“…13,22,23 In this study, blood eosinophil levels were low in both groups even when compared with the normal parameters. These data demonstrate that serum eosinophil determination does not contribute to the differential diagnoses.…”

“…Some possible explanations are as follows: 1) insect bite reaction; 2) nonspecific B lymphocyte activation during HIV infection; 3) abnormal hypersensitivity immune reaction provoked by itching; 4) pruriginous dermatosis before HIV infection; 5) systemic diseases, such as neoplasms, renal failure, pregnancy, biliary obstruction, emotional disturbances and malnutrition; and 6) abnormal cutaneous immunologic manifestations related to inversion of the normal ratio of CD41:CD81 and Th1:Th2 that could result in the inability to recognize endogenous proteins. 13 HIV-related eosinophilic folliculitis (HIV-EF) is characterized by perifollicular erythematous papules and pustules that cause intense itching. These lesions are distributed more commonly on the head, neck, upper limbs, and upper trunk.…”

“…Several reviews reported the clinical, histological, and immunohistochemical findings that distinguish HIV-PPE from HIV-EF. [8][9][10][11][12][13][14] The impact of histopathological differentiation on therapy choice was proposed by Holmes, Martins, and Horn, 15 but differential diagnosis criteria distinguishing between these two entities have not been established.…”

Clinical and Histopathological Study of Pruritic Papular Eruptions in Hiv Patients at a Tertiary Care Centre

“…Though in previous studies it was stated that lower levels of IL2 and gamma IFN and negative correlation between gamma IFN and peripheral CD4 lymphocytes may indicate an early phase of immunosuppression in PPE (23) but now it is considered as advanced sign of HIV Infection where majority of patients with PPE had CD4 count less than 200. (24) Several observational studies have reported that there is a link between low CD4 count and advanced HIV disease and as per WHO clinical staging it is included in stage III and IV and thus proposing PPE as a marker for advanced HIV.…”