Pruritic papular eruption in HIV seropositive patients: a cutaneous marker for immunosuppression

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Abstract
Background Previous reports have shown the correlation between certain skin disorders and immune status in human immunodeficiency virus (HIV) infected patients. Pruritic papular eruption (PPE) is the most common cutaneous manifestation in HIV infected patients. The purpose of this study is to define the relationship between the presentation of PPE and the immune status in HIV infection, as measured by the T‐cell subset, and to establish the usefulness of this common eruption as a predictor of CD4 count. Method In this cross‐sectional study, 20 HIV‐positive patients with characteristics of PPE were studied. Clinical data, skin biopsy, and immune status, evaluated by measuring CD4, CD8, and CD4/CD8, were investigated. Results Seventy‐five per cent of patients already had antecedent skin disorders, so PPE is not a leading symptom in HIV infected patients; 81.25% of PPE patients had an advanced degree of immunosuppression with a CD4 count below 100/mm3 and 75% below 50/mm3. Conclusions PPE can be regarded as a cutaneous marker of advanced HIV infection.