View source for Pruritic papular eruption of HIV

==Background==
{{Skin anatomy background images}}
*Most common [[rash]] of [[HIV]]<ref>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.</ref>
*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==
[[File:PMC4808702 gr1.png|thumb|Intensely pruritic papular rash with greatest severity on the extensor surfaces of extremities.]]
[[File:PMC3195174 IJSTD-32-118-g001.png|thumb|Pruritic papular eruptions as presenting illness of HIV.]]
[[File:PMC3168063 IJSTD-30-79-g002.png|thumb|Pruritic papular lesions on hands.]]
*[[Pruritus|Pruritic]]
*Diffusely, symmetrically distributed [[rash]]
**Discrete red bumps initially
**Extremities/trunk > face
**Mucous membrane sparing

==Differential Diagnosis==
*[[Folliculitis]]
*[[Cellulitis]]
*[[Fungal infection]]
*[[HSV]] infection
*[[HPV]] warts
*[[drug rash|Drug reaction]]
*[[Insect bites]]
*[[Porphyria]]

{{HIV associated conditions}}

==Evaluation==
*Appropriate clinical setting

==Management==
*Initially [[topical steroids]], emollients, PO [[antihistamines]]
*[[Doxepin]] 25 mg QHS later line PO med for those without TCA contraindication<ref>Maurer. Dermatologic Manifestations of HIV Infection. Perspective – Dermatologic Manifestations Volume 13 Issue 5 December 2005/January 2006.</ref>
*UV phototherapy for refractory cases

==Disposition==
*Outpatient dermatology follow up
*Average time for recurrence of skin condition ~8 wks

==References==
<references/>

[[Category:Dermatology]]
[[Category:ID]]