Pruritic papular eruption of HIV

Background

  • Most common rash of HIV[1]
  • Presenting symptom of HIV in up to ~80% cases
  • 3x more common when CD4 count < 200
  • Up to 46% of HIV patients have this rash at some time of disease course
  • Diagnosis of exclusion

Clinical Features

  • Pruritic
  • Diffusely, symmetrically distributed rash
    • Discrete red bumps initially
    • Extremities/trunk > face
    • Mucous membrane sparing

Differential Diagnosis

HIV associated conditions

Evaluation

  • Appropriate clinical setting

Management

Disposition

  • Outpatient dermatology follow up
  • Average time for recurrence of skin condition ~8 wks

References

  1. Cutaneous manifestations of HIV in the era of highly active antiretroviral therapy: an institutional urban clinic experience. Zancanaro PC et al. J Am Acad Dermatol. 2006 Apr;54(4):581-8.
  2. Gutteridge, David L MD, MPH, Egan, Daniel J. MD. The HIV-Infected Adult Patient in The Emergency Department: The Changing Landscape of the Disease. Emergency Medicine Practice: An Evidence-Based Approach to Emergency Medicine. Vol 18, Num 2. Feb 2016.
  3. Maurer. Dermatologic Manifestations of HIV Infection. Perspective – Dermatologic Manifestations Volume 13 Issue 5 December 2005/January 2006.