Question | Discussion | References

Updated February 20, 2013

Pruritic Papular Eruption of HIV (PPE-HIV)

Authors: Kate Khorsand, BS Roy Colven, MD

A 28-year-old HIV-infected man with an absolute CD4 count of 124 cells/mm3 presents with a 10-week history of erythematous and hyper- and hypopigmented papules distributed diffusely on the legs, arms, and dorsal surfaces of the hands (Figure 1). The patient reports that the papules are intensely itchy and persist for weeks. On examination, some of the papules show central erosion consistent with excoriation. A diagnosis of pruritic papular eruption of HIV (PPE-HIV) is suspected.

Which one of the following statements is TRUE regarding pruritic papular eruption in HIV-infected persons?

A Typical antipruritic measures are usually effective in relieving the itching associated with this condition.
B Pruritic papular eruption is a rare condition in HIV-infected persons, typically seen in patients with high CD4 counts.
C Biopsy and histologic examination of one or more lesions helps to distinguish pruritic papular eruption from other HIV-related conditions that can present with similar findings. .
D A predominance of pustules favors the diagnosis of pruritic papular eruption over infective causes such as bacterial or fungal folliculitis.

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    Figure 1. Diffuse, itchy papules suggestive of PPE-HIV
    Figure 1