HIV Papular Pruritic Eruption
Description Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: T78.4 DESCRIPTION A chronic itchy condition with a relapsing course. In HIV-infected patients, insect bites may be severe and recalcitrant with post-inflammatory pigmentation and scarring. DIAGNOSTIC CRITERIA Initial lesion is a pruritic urticarial spot with a cen
General and supportive measures
ICD-10 code: T78.4
DESCRIPTION
A chronic itchy condition with a relapsing course. In HIV-infected patients, insect bites may be severe and recalcitrant with post-inflammatory pigmentation and scarring.
DIAGNOSTIC CRITERIA
- Initial lesion is a pruritic urticarial spot with a central red punctum.
- Lesions progress to pruritic papules with or without blisters. Scratching lesions may cause inflammatory changes, erosions, crusts or scabs with secondary infection.
- Post-inflammatory pigmentation and scarring are common.
GENERAL AND SUPPORTIVE MEASURES
- Prevent insect bites with use of, insect repellents.
- Eradicate fleas and other insects.
MEDICINE TREATMENT
- Calamine lotion, topical, applied as needed.
AND
- Chlorphenamine, oral, 0.1 mg/kg/dose 6 hourly.
AND
- Betamethasone 0.1%, topical, applied 12 hourly for 3 days.
THEN, until pruritus subsides:
- Face: Hydrocortisone 1%, topical applied 12 hourly.
- Body: Betamethasone 0.1%, topical applied 12 hourly.
Treat secondary infection with an appropriate antibiotic, if indicated.
Treatment of HIV. See Human Immunodeficiency Virus Infections.
REFERRAL
- No response to treatment.
Standard Treatment Guidelines And Essential Medicines List For South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 5: Dermatology, 5.5. Vesicles And Pustules, 5.5.2 Skin And Mucosal Disorders In HIV, 5.5.2.1 HIV Papular Pruritic Eruption