What causes pruritic papular eruption of HIV?
Strictly this rash is a diagnosis of exclusion, when all other causes have been ruled out. This means that currently there is no identified cause. Arthropod bites, medications, autoimmunity and direct HIV infection of the skin have all been considered, but not proven. Unfortunately many reports in the literature include a number of other conditions under the heading of pruritic papular eruption of HIV. These include • Folliculitis • Staphylococcus infections • Malassezia infections • Eosinophilic folliculitis • Herpes simplex virus infections • Pseudomonas infections • Infection with Gram negative rods (eg Klebsiella, enterobacter) • Demodicidosis • Insect bite reactions • Granulomas • Granulomatous drug reactions • Lichenoid and granulomatous dermatitis of AIDS • Post viral granulomatous reaction • Acne It is necessary to consider and exclude these other conditions before a diagnosis is made. In most cases a skin biopsy is required.
