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
Related Articles
- EP ID EP232607
- DOI 10.14260/Jemds/2017/1050
- Views 87
- Downloads 0
EVALUATION OF LACTATE DEHYDROGENASE- A BIOCHEMICAL MARKER OF PREECLAMPSIA
BACKGROUND Serum LDH level is a useful predictive biochemical marker of cellular injury which reflects the severity of preeclampsia. It is a prognostic marker for both mother and foetus. Hence, its assay is useful to dec...
INTRAOPERATIVE MANAGEMENT OF PHEOCHROMOCYTOMA RESECTION- A CASE REPORT
PRESENTATION OF CASE A 36 years old female, weighing 55 kg presented with the complaint of palpitation since one month. On general examination, she had a pulse of 110/min and blood pressure 160/100 mmHg. There was a palp...
RENAL RESISTIVE INDEX AS A PREDICTOR OF ACUTE HYDRONEPHROSIS IN PATIENTS WITH RENAL COLIC
BACKGROUND Urolithiasis remains a major health problem worldwide. Patients with renal colic are 33% to 68.3% at risk of acute urinary obstruction (partial or complete) leading to hydroureteronephrosis. Our study was done...
HISTOLOGICAL STUDY OF BLOOD VESSEL WALL FIBROSIS IN VARICOSE VEINS
BACKGROUND Varicose veins affect around 10% of the population, various theories have been postulated about the pathophysiology of the varicose veins. Vessel wall fibrotic changes and subsequent valvular incompetence is t...
EPONYMS IN HERNIA SURGERY
BACKGROUND The saying goes “The history of hernia repair is the history of surgery”. The history of open surgery for groin hernia has gone through many stages of development starting from the Romans, Greeks and the Egypt...