Pruritic papular eruption of the acquired immunodeficiency syndrome: A clinicopathologic study

Hevia, Oscar; Jiménez‐Acosta, F.; Ceballos, Patricia I.; Gould, Edwin W.; Penneys, Neal S.

doi:10.1016/0190-9622(91)70033-x

Cited by 84 publications

(35 citation statements)

References 22 publications

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“…(1991) mentioned histological and clinical criteria for the diagnosis of these lesions. [15] Most of the cases of PPE in our study were seen with CD4 counts more than 350 cells/cumm. We have found only 4.54% cases, which was similar to other studies in India (Mumbai 3%) and Asia (Thailand 4.7%) indicating low incidence in Asian patients.…”

Section: Discussionmentioning

confidence: 76%

Dermatological manifestations in human immunodeficiency virus infected patients: Morphological spectrum with CD4 correlation

Chawhan

Bhat

Solanke

2013

Indian J Sex Transm Dis

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Background:More than 90% of human immunodeficiency virus (HIV) infected patients develop skin lesions at some time throughout the course of the disease. Several skin diseases have proved to be sensitive and useful indicators of progression of HIV infection. Although these conditions may be seen in general healthy population, their occurrence in patients with acquired immunodeficiency syndrome is often atypical, more severe and explosive.Aims:The present study was carried out to categorize the skin lesions by histopathology using punch biopsy or cytology when feasible in HIV infected patients and to see the correlation for various skin lesions with CD4 counts.Materials and Methods:In total 110 known HIV positive patients with the symptomatic skin lesions, cytology and punch biopsy was correlated with CD4 counts.Results:Maximum patients were between 31 and 40 years. 53 (48.18%) patients had infectious and 37 (34.55%) patients had non-infectious lesions. Out of 110 patients, CD4 counts were available in 70 patients. The spectrum of various non-infectious and infectious lesions such as viral, bacterial, fungal, protozoa and their association with CD4 counts is discussed.Conclusions:CD4 counts below 200 were associated with the maximum infectious lesions, whereas CD4 counts more than 350 showed more of the non-infectious lesions. Most common infectious lesion was Molluscum contagiosum. The most common non-infectious lesion was pruritic papular eruptions.

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Section: Discussionmentioning

confidence: 76%

Dermatological manifestations in human immunodeficiency virus infected patients: Morphological spectrum with CD4 correlation

Chawhan

Bhat

Solanke

2013

Indian J Sex Transm Dis

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“…Furthermore, the insect bite-like reaction in these patients shares features or may be even identical to the papular rash described in patients with human immunodeficiency virus infection. 10,11 Therefore, immunodeficiency combined with various immunologic stimuli (insect bites, drugs, or viral infections) may play a role in the pathogenesis of both eruptions. It is also likely that Wells syndrome, which has been described in patients with malignant hematologic disorders, 12 is nothing but a variant of this insect bite-like reaction.…”

Section: Laboratory Methodsmentioning

confidence: 99%

Insect Bite–like Reaction in Patients With Hematologic Malignant Neoplasms

Barzilai¹,

Shpiro²,

Goldberg³

et al. 1999

Arch Dermatol

115

195

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Background: Exaggerated reaction to insect bites, mainly to mosquitoes, is infrequently described in patients with chronic lymphocytic leukemia. Skin lesions usually appear months to years after the diagnosis of leukemia and are unrelated to laboratory findings, disease course, or therapy.Observations: We describe 8 patients with various hematologic disorders (chronic lymphocytic leukemia, acute lymphoblastic leukemia, acute monocytic leukemia, mantle-cell lymphoma, large-cell lymphoma, and myelofibrosis) who developed insect bite-like reaction. Although the clinical picture and the histological characteristics of the lesions were typical for insect bites, none of the patients actually had a history, course, or response to treatment suggestive of arthropod assaults. In 2 patients, the eruption preceded the diagnosis of the ma-lignant neoplasm. The rash persisted for months to years and was resistant to therapies other than systemic corticosteroids. The 3 patients with chronic lymphocytic leukemia seemed to have a worse prognosis than expected for their disease. In 1, the polymerase chain reaction detected leukemic cells in the infiltrate.Conclusions: Insect bite-like reaction is an infrequent, disturbing, and difficult-to-treat nonspecific phenomenon in patients with hematologic malignant neoplasms. Since it may precede the hematologic disorder, oriented evaluation is warranted. We speculate that immunodeficiency plays a role in its pathogenesis; however, the exact pathogenesis and its prognostic implications await further studies.

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“…In the most detailed study of dermal hypersensitivity reaction pattern, 1 the conclusion reached was that this does not represent any particular clinical disorder but could be seen as part of urticaria, drug reaction, or eczema, and is found in a subgroup of patients with persistent excoriated papules on the trunk. The latter has been reported as a variant of papular urticaria, simply as a pruritic papular eruption, [5][6][7] subacute prurigo, [8][9][10] or itchy red bump disease, 10,11 and remains an enigmatic subgroup. 12 Our study differs in that the term urticarial dermatitis has been used to identify a subset of patients with urticarial plaques and papules, providing a link to a group of dermatological conditions with urticarial features that represent a predominantly dermal eczematous reaction.…”

Section: Commentmentioning

confidence: 99%