CLINICAL AND HISTOPATHOLOGICAL STUDY OF PRURITIC PAPULAR ERUPTIONS IN HIV PATIENTS AT A TERTIARY CARE CENTRE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 68
Abstract
BACKGROUND Pruritic 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. MATERIALS AND METHODS The prospective study is conducted in Department of Dermatology at Rangaraya Medical College, Kakinada, Andhra Pradesh. 78 clinically diagnosed cases of PPE were enrolled in the study after confirming HIV status and evaluated clinicohistopathological spectrum of PPE. CD4 count was done in all cases. RESULTS Out of 78 cases of PPE, 34 were male and 44 were female. 85% of cases belong to 20-40 years age group. Heterosexual route is the major mode of transmission in 74 cases (94.9%). Histopathological concordance was achieved in only 60 cases of PPE (76.92%). Grade-1 only extremities in 5 cases (9%), Grade-2 Trunk and extremities in 33 cases (55%) and Grade-3 generalised in 22 cases (36%). Histology showed hyperkeratosis, acanthosis in 47 cases (78.33%), spongiosis in 38 cases (63.3%) and perivascular, periadnexal, perifollicular infiltration of lymphocytes in all cases of PPE. CD4 counts less than 200 were found in 42 (71.66%) PPE cases. CONCLUSION PPE of HIV is an independent entity distinguished from other conditions like eosinophilic folliculitis and papular urticaria by the involvement of perivascular, periadnexal and perifollicular infiltration of lymphocytes which is the characteristic feature. This work highlights the necessity of histopathology for proper diagnosis and management of PPE in HIV patients.
Authors and Affiliations
Indira Bonthu, Ramachandra B. V, Nivedita Devi V, Lakshmi P. V, Satyanarayana V. V. V, Swarnakumari G. , Sridevi L. , Anilkumar T. P
Keywords
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- EP ID EP232607
- DOI 10.14260/Jemds/2017/1050
- Views 65
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