Rube J. Pardo

UVB phototherapy of the pruritic papular eruption of the acquired immunodeficiency syndrome

BACKGROUND Pruritic papular eruption (PPE) is a chronic dermatosis frequently seen in human immunodeficiency virus (HIV)-positive patients. UVB phototherapy has been successfully used to treat a similar inflammatory condition (Ofuji disease) as well as pruritus of systemic origin. OBJECTIVE We describe the successful treatment with UVB of seven of eight patients with PPE. METHODS Eight HIV-positive patients with PPE were treated. The number of papules in a specified area of skin and the intensity of pruritus were monitored before, during, and after UVB phototherapy given three times a week. Biopsy specimens were taken before and after therapy and systemic immune function was evaluated. RESULTS Both the number of papules as well as pruritus decreased after UVB treatment in all but one patient. Immunoperoxidase staining showed a relative decrease in CD4+, CD8+, and CD2+ cells in all samples studied except for the patient noted to be unresponsive to the therapy. CONCLUSION UVB phototherapy is effective in the treatment of patients with PPE. This is associated with a significant decrease in inflammation and number of T cells from various subsets within the dermis, thereby implicating these cells in the pathogenesis of this disorder.

PORPHYRIA CUTANEA TARDA AND HUMAN IMMUNODEFICIENCY VIRUS INFECTION

Porphyria cutanea tarda (PCT), a relatively uncommon disease, has recently been reported in patients infected with the human immunodeficiency virus (HIV). Although PCT and HIV infection may co‐exist by chance, the increasing number of reported cases suggest that HIV or an associated factor triggers the development of PCT in predisposed individuals. We report four additional cases of PCT in HIV seropositive patients and review the previously reported cases. The possible links between PCT and HIV are discussed. We believe the diagnosis of PCT should prompt investigation for HIV infection in all patients.

Pityriasis rubra pilaris and HIV infection

Many cutaneous diseases have been reported in patients with human immunodeficiency virus infection. We report two patients with pityriasis rubra pilaris and human immunodeficiency virus infection. In one patient, the onset of pityriasis rubra pilaris preceded the discovery of human immunodeficiency virus infection. In the second patient, the onset of pityriasis rubra pilaris occurred shortly after the patient tested positive for human immunodeficiency virus infection. Both patients had a severe form of pityriasis rubra pilaris, and both had a minimal therapeutic response to etretinate.

Bacillary angiomatosis of acquired immunodeficiency syndrome: Case report and literature review

We report a case of bacillary angiomatosis of acquired immunodeficiency syndrome, so that dermatologists might become more aware of this easily treatable disease .A brief review of the literature is included .

Hypertrophic Lichen Planus and Light Sensitivity in an HIV‐Positive Patient

ABSTRACT: A 40‐year‐old black man who was HIV positive developed generalized hypertrophic lichen planus in areas previously affected by a photosensitivity eruption. After unsuccessful attempts to induce remission of his lichen planus with conventional therapies, etretinate produced a dramatic response.

Studies of immunoglobulin and T cell receptor gene rearrangement in cutaneous B and T cell lymphomas

We report two patients with cutaneous B and T cell lymphomas, respectively, in which DNA rearrangement studies were instrumental in establishing a diagnosis. In each case clinical, histopathologic, and immunologic criteria were not sufficient to establish a definitive tissue classification. The use of DNA gene rearrangement studies in the analysis of cutaneous lymphomas is discussed.

Borderline tuberculoid Hansen's disease in AIDS

We performed an immunohistochemical analysis of a skin lesion from a patient with AIDS who had borderline tuberculoid Hansens disease. We also evaluated other laboratory features and performed peripheral blood flow cytometric analysis. The in situ immunologic response to Mycobacterium leprae was minimally affected by concomitant infection and immunosuppression by HIV. The skin demonstrated the typical characteristics of borderline tuberculoid lesions. These results indicate that although a patient with HIV infection may have laboratory evidence typical of the immunosuppression seen in AIDS, the immunologic response to M. leprae is essentially unchanged.