Pruritic Papular Eruptions and Candidiasis Due to HIV Infection

Abstract

We present two patients with refractory papular eruptions and severe candidiasis. Both of them are positive for treponema pallidum and have suffered from pruritic papular eruptions (PPE) that had resisted therapy for years. Also, candidiasis appeared in the mouth, at intertriginous sites, and on the feet. The clinical features suggested immunodeficiency, and HIV tests were positive. Histologically, the specimen from the PPE lesion showed perivascular and perifollicular mixed cell infiltration. The fungus was identified by both Parker-KOH-mount examination and mycologic culture as Candida albicans. The pruritic papules were healed almost completely with oral antihistamine and topical corticosteroid treatment, and the candidiasis mostly disappeared after treatment with topical antifungal agents alone. We learned from these two cases that refractory PPE and severe candidiasis indicate a need for HIV testing.

HIV‐Associated Eosinophilic Pustular Folliculitis: Successful Treatment of a Japanese Patient with UVB Phototherapy

“…As suggested by many authors (8,15,19), these two diseases seem to lie within the same histologic and clinical spectrum. The chronic persistent eruption on the trunk in our patient, manifesting multiple, excoriated, prurigolike nodules, was typical of that in reported cases of pruritic papular eruption (18,20), which is considered to be a chronic and long-standing eruption of HIV-associated eosinophilic pustular folliculitis. However, another type of "papular eruption" reported to occur in patients with HIV infection, which shows the histologic features of dermal fibrosis or granuloma (21,22), should be considered as a completely different clinicalentity (19).…”

“…Cases of HIV infection, an entity showing similar clinicopathological features to the HIV-associated form, were also reported under the term pruritic papular eruption (15). A few Japanese cases of pruritic papular eruption associated with HIV infection have been reported (16)(17)(18). As suggested by many authors (8,15,19), these two diseases seem to lie within the same histologic and clinical spectrum.…”

A Retrospective Survey of Mucocutaneous Manifestations of HIV Infection in Malaysia: Analysis of 182 Cases

“…Some of the research showed that the presence of papular eruptions predicts the advanced disease of HIV infection. A former study also revealed that this problem correlates with considerable morbidity .ling and is poorly responsive to conventional therapy (21)(22)(23)(24)(25).…”

Mucocutaneous manifestations of HIV infection: a retrospective analysis of 145 cases in a Chinese population in Malaysia

“…A former study also revealed that this problem causes considerable morbidity and is poorly responsive to conventional therapy. [21][22][23][24][25]…”