Thread by @Sthanu5

This young patient with HIV has these itchy lesions.

Diagnosis?

Answer

HIV-associated eosinophilic folliculitis

Eosinophilic folliculitis (EF) is a pruritic skin eruption

👉 follicular papules or pustules, predominantly located on the scalp, face, neck, and upper chest

👉common skin eruption in patients with advanced HIV disease

Eosinophilic folliculitis is often a feature of immunodeficiency.

Eosinophilic pustular folliculitis associated with HIV infection presents when levels of CD4 lymphocyte cells drop below 300 cells/mm3

👉 level at which there is an ⤴️ risk of a secondary opportunistic infection

HIV-associated eosinophilic folliculitis

👉 2–3 mm erythematous, highly pruritic wheal-like papules,

👉most frequently affecting the shoulders, trunk, upper arms, neck and forehead

Lesions are follicular and are often markedly excoriated.

👉 mild eosinophilic folliculitis with topical steroids and oral antihistaminics.

👉 moderate disease with oral itraconazole, isotretinoin, or phototherapy.

👉 severe eosinophilic folliculitis with isotretinoin therapy for several months.

Clinical differential diagnoses include

tinea,

acne,

rosacea,

eczematous dermatitis,

granuloma faciale,

autoimmune annular erythema,

infestations

pustular dermatosis.

The hyperimmunoglobulin E syndrome may be first evident as eosinophilic pustular folliculitis.

https://t.co/Cwc95LdTPqpcds.org.uk/clinical-guida…
infectiousdiseaseadvisor.com

@VincentMuraya Papular Pruritic Eruptions

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