Etiology of Pruritic Papular Eruption With HIV Infection in Uganda

Resneck, Jack S.; VanBeek, Marta; Furmanski, Lisa; Oyugi, Jessica H.; LeBoit, Philip E.; Katabira, Elly; Kambugu, Fred; Maurer, Toby; Berger, Tim; Pletcher, Mark J.; Machtinger, Edward L.

doi:10.1001/jama.292.21.2614

Cited by 86 publications

(61 citation statements)

References 24 publications

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“…Patients who have Th2 dominance may be more predisposed to the development of arthropod hypersensitivity leading to PPE. (16) The severity of PPE was evaluated by asking two questions whether the lesions were itchy for the past one month or not and whether the lesions were interfering with sleep or not. (17) Using the rash severity scale, the severity of skin rash was not significantly associated with the CD4 count.…”

Section: Discussionmentioning

confidence: 99%

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

Bonthu¹,

Ramachandra²,

Devi³

et al. 2017

jemds

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BACKGROUNDPruritic Papular Eruption (PPE) of HIV is the commonest cutaneous manifestation seen in HIV positive patients. PPE clinically presents as bilaterally symmetrical itchy papules over trunk and extremities especially in late stages of HIV infection posing a therapeutic challenge to the clinician for precise diagnosis and management. Aims and Objectives-The present study was aimed to separate Pruritic papular eruption of HIV (PPE) which is an independent entity that clinically resembles other dermatoses presenting as pruritic papular lesions on the basis of clinical and histopathological data and to correlate with CD4 count.

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Section: Discussionmentioning

confidence: 99%

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

Bonthu¹,

Ramachandra²,

Devi³

et al. 2017

jemds

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“…13 Many reports support the raising prevalence of these noninfective disorders in patients on HAART. [14][15][16][17][18][19][20] Among the non-infectious manifestations, pruritic papular eruption was found to be the most prevalent manifestation of PLWH on HAART.…”

Section: Discussionmentioning

confidence: 99%

Mucocutaneous manifestations among persons receiving highly active anti-retroviral therapy

2017

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Background: Mucocutaneous manifestations in patients positive for HIV are helpful in the diagnosis as well as treatment of the disease. Consequent to the introduction of Highly Active Anti-Retroviral Therapy (HAART), there seems to be an increase in the presentation of non-infective diseases. It was aimed to analyse the mucocutaneous manifestations in HIV infected patients taking HAART and correlate with age and CD4 lymphocyte count.Methods: A retrospective analysis of 125 People Living With HIV (PLWH) having mucocutaneous manifestations receiving HAART who attended a tertiary care city hospital over a period of ten months from January 2016 to October 2016 was carried out. The findings were correlated with CD4 count and age. The data were collected from the patient follow up cards maintained by qualified Dermatovenereologist.Results: There was no major gender difference in our study. The trans genders presented with only non-infectious skin diseases. Younger patients had a higher CD4 count (p=0.01%) which was statistically significant. Candidiasis and pruritic papular eruption were the commonest infective and non-infective diseases observed respectively. The mean CD4 count comparison was statistically significant (p=0.04). The count was highest for insect bite allergy and lowest for oral hairy leukoplakia. The mean age of disease manifestation was highest for Herpes zoster and lowest for aphthous ulcers 45 and 29 years respectively. All the adverse reactions observed were to efavirenz. Conclusions: With the improvement of CD4 count in PLWH receiving HAART, the proportion of non-infectious inflammatory disease manifestations are on the rise. Awareness about this fact is very important for effective management.

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“…The characteristic of skin problems in HIV-infected individuals clearly indicates immunosuppression and have accompanied AIDS from early days of the epidemic (Piot et al, 1984;WHO, 1987). PPE is a cutaneous marker of advanced HIV-infection and is known to be uncommon in immunecompetent persons (Resneck et al, 2004;Eisman, 2006). Kaposi's sarcoma and Herpes zoster are companions of skin problems in AIDS patients.…”

Section: Discussionmentioning

confidence: 99%

Management of HIV and AIDS at lower primary health care facility in Chalinze, eastern Tanzania

Idindili¹,

Jullu

Mugusi

et al. 2011

Tanzania J Hlth Res

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Implementation of Antiretroviral Therapy (ART) services at health centres in Tanzania were delayed due to several reasons including shortage of qualified staff, inadequate infrastructure and logistics problems. However, patients from peripheral areas experienced difficulties in accessing ART services due to long distances from clinics. National AIDS Control Programme (NACP) and NonGovernmental Organizations (NGOs) embarked on ART services scale-up programme aimed at improved ART availability and accessibility. Through this programme ART services were established at health centres and selected dispensaries. However, no previous documented experiences existed at country level to guide provision of services. Therefore, this study was designed to gather experiences and share lessons learnt with other health care providers and programme implementing partners. This was a descriptive cross-sectional study involved patients enrolled to ART services between May 2007 and April 2009. Data collection involved observation of health providers' performance and retrospective ART and care patients' registers review. During the study period, 611 care and 284 ART patients were attended. Majority of patients (85.1%; 762/895) were adults aged 25-45 years. In total 61.5% (550/895) of the patients had CD4+T lymphocytes ≤350/µl the cut-off point for initiating ART. The frequency of symptoms was noted to significantly decrease with increasing CD4 counts (P<0.001). Numbness, parotid enlargement and genital discharge were not related to patient level of CD4+T-lymphocytes counts. Papular pruritic eruptions 98/282 (34.8%), tuberculosis 86/282 (30.5%) and oesophageal candidiasis 37/282 (13.1) were the most diagnosed AIDS defining illnesses. Sixteen patients on care died and 30 were lost to follow up. Overall the clinical management was poorly performed. ART services can successively be provided at health centre level and encourages HIV-infected persons to seek care. However, clinicians need regular clinical mentorship and supportive supervision.

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Etiology of Pruritic Papular Eruption With HIV Infection in Uganda

Cited by 86 publications

References 24 publications

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

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

Mucocutaneous manifestations among persons receiving highly active anti-retroviral therapy

Management of HIV and AIDS at lower primary health care facility in Chalinze, eastern Tanzania

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