FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2028408032> ?p ?o ?g. }

• W2028408032 endingPage "111" @default.
• W2028408032 startingPage "109" @default.
• W2028408032 abstract "Pruritic papular eruption of HIV (PPE) represents an intensely pruritic papular rash with greatest severity on the extensor surfaces of extremities. It is one of the most common cutaneous manifestations in HIV-infected individuals, in whom prevalence ranges between 11% and 46% depending on geographic location.1Resneck J.S. Van Beek M. Furmanski L. et al.Etiology of pruritic papular eruption with HIV infection in uganda.JAMA. 2004; 292: 2614-2621Crossref PubMed Scopus (63) Google Scholar, 2Colebunders R. Mann J.M. Francis H. et al.Generalized papular pruritic eruption in African patients with human immunodeficiency virus infection.AIDS. 1987; 1: 117-121PubMed Google Scholar, 3Sivayathorn A. Srihra B. Leesanguankul W. Prevalence of skin disease in patients infected with human immunodeficiency virus in Bangkok, Thailand.Ann Acad Med Singapore. 1995; 24: 528-533PubMed Google Scholar, 4Rosatelli J.B. Machado A.A. Roselino A.M. Dermatoses among Brazilian HIV-positive patients: correlation with the evolutionary phases of AIDS.Int J Dermatol. 1997; 36: 729-734Crossref PubMed Scopus (39) Google Scholar, 5Liautaud B. Pape J. DeHovitz J.A. et al.Pruritic skin lesions. A common initial presentation of acquired immunodeficiency syndrome.Arch Dermatol. 1989; 125: 629-632Crossref PubMed Scopus (69) Google Scholar Persistent or recurrent PPE despite effective antiretroviral therapy (ART) may be associated with higher viral load at ART initiation.6Chua S.L. Amerson E.H. Leslie K.S. et al.Factors associated with pruritic papular eruption of human immunodeficiency virus (HIV) infection in the antiretroviral therapy eta.Br J Dermatol. 2014; 170: 832-839Crossref PubMed Scopus (10) Google Scholar Although pathogenesis is uncertain, an exaggerated immunologic reaction to arthropod bites has been suggested because of geographical restriction to the tropics, localization to the extremities, similarity in histology, and increased peripheral eosinophil counts.1Resneck J.S. Van Beek M. Furmanski L. et al.Etiology of pruritic papular eruption with HIV infection in uganda.JAMA. 2004; 292: 2614-2621Crossref PubMed Scopus (63) Google Scholar The optimum treatment pathway is poorly defined because of lack of evidence for different treatment modalities. We report a case of recurrent PPE responding well to oral thalidomide during a 3-month treatment period. A 44-year-old Zimbabwean woman living in the United Kingdom since 1998 had HIV diagnosed in 2006. At the time of diagnosis, her CD4 count was 204 cells per cubic millimeter and viral load was 498,000 copies per milliliter. ART was started, which resulted in a sustained suppression of HIV viremia (viral load <40 copies/mL, CD4 >600 cells per cubic millimeter). A year later a pruritic eruption developed starting on the upper arms and spreading to the hands, thighs, and back. Initial treatment with topical betamethasone valerate 0.1% was effective, but a relapse occurred 4 years later. On returning she described a 1-month history of an intensely pruritic rash affecting the trunk, arms, and legs. Examination found numerous monomorphic hyperpigmented papules on the extensor surface of the limbs and on the trunk (Fig 1). The face, hands, feet, and mucous membranes were spared. Histologic analysis found a dermal perivascular lymphocytic infiltrate with scattered eosinophils (Fig 2). The patient had PPE diagnosed based on the clinical findings and histology. Initial management with clobetasol propionate 0.05% ointment applied daily and high dose oral antihistamines was minimally effective. Thirty narrowband ultraviolet B phototherapy treatments led to significant improvement, but a relapse occurred 2 weeks after termination of therapy. Dapsone was considered but precluded because of glucose-6-phosphate dehydrogenase deficiency. Based on its efficacy in HIV-infected patients with prurigo nodularis, the patient was prescribed a trial of thalidomide at a dose of 100 mg daily.7Maurer T. Poncelet A. Berger T. Thalidomide treatment for prurigo nodularis in human immunodeficiency virus-infected subjects: efficacy and risk of neuropathy.Arch Dermatol. 2004; 140: 845-849Crossref PubMed Scopus (53) Google Scholar Before commencement of treatment, the patient was counselled regarding the risks of peripheral neuropathy and teratogenicity. Two forms of contraception, condoms and an intrauterine device, were used throughout the treatment period. We measured baseline severity and response to treatment using the Dermatology Life Quality Index (DLQI) and a 10-cm visual analogue score (VAS) for pruritus. At the start of treatment, DLQI was 26/30 and VAS was 7/10. By 3 months of treatment, there was almost complete resolution of symptoms with a DLQI of 2/30 and VAS 1/10 (Fig 3, Fig 4). Thalidomide was withheld at 3 months followed by a 4-month remission. At the time of flare of the rash and pruritus, thalidomide was recommenced at the same daily dose, which led to similar improvement in symptoms. Treatment was withheld by the patient at 5 months. She reported only few residual pruritic papules, treated with topical betamethasone valerate 0.1% cream. PPE remains suppressed 5 months after treatment discontinuation. There were no significant adverse effects and no clinical evidence of thalidomide-induced peripheral neuropathy during either treatment period.Fig 4Graph shows the reduction in VAS pruritus score from 7 down to 1.View Large Image Figure ViewerDownload (PPT) Differential diagnoses to consider in patients with HIV and pruritus include PPE, prurigo nodularis, and eosinophilic folliculitis. In our case, there was no perifollicular inflammation on histology, which would be expected with eosinophilic folliculitis. In contrast to prurigo nodularis, the rash was papular rather than nodular, and the histology lacked typical features of compact orthohyperkeratosis, acanthosis, hypergranulosis, and papillary dermal fibrosis with vertical alignment of collagen fibers.8Weigelt N. Metze D. Ständer S. Prurigo nodularis: systematic analysis of 58 histological criteria in 136 patients.J Cutan Pathol. 2010; 37: 578-586Crossref PubMed Scopus (73) Google Scholar Few studies have identified beneficial therapeutic approaches for PPE, and these are primarily observational studies, case series, or case reports. Currently, there are no randomized controlled trials undertaken to study interventions for PPE. For diagnosis before ART commencement, dramatic responses have been documented in response to ART initiation, with one study reporting complete resolution without recurrence in 86% of their cohort.9Castelnuovo B. Byakwaga H. Menten J. Schaefer P. Kamya M. Colebunders R. Can response of a pruritic papular eruption to antiretroviral therapy be used as a clinical parameter to monitor virological outcome?.AIDS. 2008; 22: 269-273Crossref PubMed Scopus (25) Google Scholar Initial skin treatment in these circumstances may involve potent topical corticosteroids and high-dose oral antihistamines.10Navarini A.A. Stoeckle M. Navarini S. et al.Antihistamines are superior to topical steroids in managing human immunodeficiency virus (HIV)-associated papular pruritic eruption.Int J Dermatol. 2010; 49: 83-86Crossref PubMed Scopus (8) Google Scholar, 11Lakshmi S.J. Rao G.R. Ramalakshmi Satyasree Rao K.A. Prasad P.G. Kumar Y.H. Pruritic papular eruptions of HIV: A clinicopathologic and therapeutic study.Indian J Dermatol Venereol Leprol. 2008; 74: 501-503Crossref PubMed Scopus (6) Google Scholar Narrowband ultraviolet B and psoralen and ultraviolet A have been reported to be effective, although the period of remission may be brief.12Bellavista S. D'antuono A. Infusino S.D. Trimarco R. Patrizi A. Pruritic papular eruption in HIV: a case successfully treated with NB-UVB.Dermatol Ther. 2013; 26: 173-175Crossref PubMed Scopus (6) Google Scholar Other systemic treatments reported to be effective in observational studies are dapsone and pentoxyfylline.11Lakshmi S.J. Rao G.R. Ramalakshmi Satyasree Rao K.A. Prasad P.G. Kumar Y.H. Pruritic papular eruptions of HIV: A clinicopathologic and therapeutic study.Indian J Dermatol Venereol Leprol. 2008; 74: 501-503Crossref PubMed Scopus (6) Google Scholar, 13Berman B. Flores F. Burke G. Efficacy of pentoxifylline in the treatment of papular pruritic eruption of HIV-infected persons.J Am Acad Dermatol. 1998; 38: 955-959Abstract Full Text Full Text PDF PubMed Scopus (29) Google Scholar Oral thalidomide requires strict monitoring for the development of peripheral neuropathy, reported to occur in up to 55.6% of treated dermatologic patients.14Bastuji-Garin S. Ochonisky S. Bouche P. et al.Incidence and risk factors for thalidomide neuropathy: a prospective study of 135 dermatologic patients.J Invest Dermatol. 2002; 119: 1020-1026Crossref PubMed Scopus (148) Google Scholar Compliance with pregnancy prevention is important as exposure to the fetus can lead to multiple birth defects, including phocomelia and thumb absence/hypoplasia.15Martínez-Frías M.L. The thalidomide experience: review of its effects 50 years later.Med Clin (Barc). 2012; 139: 25-32Crossref PubMed Scopus (15) Google Scholar The mechanism for treating pruritic skin disease is not well characterized but may involve a combination of actions. Thalidomide acts as a central depressant with sedative properties, which may be beneficial in disrupting the itch-scratch cycle.16Daly B.M. Shuster S. Antipruritic action of thalidomide.Acta Derm Venereol. 2000; 80: 24-25Crossref PubMed Scopus (40) Google Scholar In prurigo nodularis, a local effect on proliferated neural tissue has been suggested.17van den Broek H. Treatment of prurigo nodularis with thalidomide.Arch Dermatol. 1980; 116: 571-572Crossref PubMed Scopus (82) Google Scholar Suppression of tumor necrosis factor alfa and increased production of cytokines, including interleukin-2 and interleukin-12 may also play a role.18Corral L. Kaplan G. Immunomodulation by thalidomide and thalidomide analogues.Ann Rheum Dis. 1999; 58: I107-I113Crossref PubMed Scopus (172) Google Scholar Our decision to run a trial of thalidomide was based on its efficacy and relative safety in a small case series of patients with HIV and prurigo nodularis and also its previously demonstrated efficacy in other pruritic conditions. In the case series by Maurer et al,7Maurer T. Poncelet A. Berger T. Thalidomide treatment for prurigo nodularis in human immunodeficiency virus-infected subjects: efficacy and risk of neuropathy.Arch Dermatol. 2004; 140: 845-849Crossref PubMed Scopus (53) Google Scholar all 8 subjects had a greater than 50% reduction of pruritus over an average of 3.4 months, and 7 of 8 patients had greater than 50% reduction in clinical scoring. The treatment was generally well tolerated without significant adverse effects, although a reversible thalidomide-induced peripheral neuropathy developed in 3 of 8 patients. No correlation was found between thalidomide and reduction of CD4 count. Viral load was not measured during thalidomide therapy.9Castelnuovo B. Byakwaga H. Menten J. Schaefer P. Kamya M. Colebunders R. Can response of a pruritic papular eruption to antiretroviral therapy be used as a clinical parameter to monitor virological outcome?.AIDS. 2008; 22: 269-273Crossref PubMed Scopus (25) Google Scholar Our patient had sustained virologic suppression throughout both thalidomide treatment periods with viral load less than 40 copies per milliliter and CD4 counts between 600 and 800 cells per cubic millimeter. We present a case of recurrent PPE responding to oral thalidomide. Further studies are needed to identify the optimum dosing regimen, efficacy, and safety in this population." @default.
• W2028408032 created "2016-06-24" @default.
• W2028408032 creator A5017119601 @default.
• W2028408032 creator A5056847511 @default.
• W2028408032 creator A5081284457 @default.
• W2028408032 date "2015-05-01" @default.
• W2028408032 modified "2023-09-27" @default.
• W2028408032 title "Thalidomide—A novel therapeutic approach for pruritic papular eruption of HIV" @default.
• W2028408032 cites W1484595179 @default.
• W2028408032 cites W1604523937 @default.
• W2028408032 cites W1825892450 @default.
• W2028408032 cites W1973375312 @default.
• W2028408032 cites W1982377576 @default.
• W2028408032 cites W2001395012 @default.
• W2028408032 cites W2018765368 @default.
• W2028408032 cites W2020843515 @default.
• W2028408032 cites W2027412145 @default.
• W2028408032 cites W2028926585 @default.
• W2028408032 cites W2043909087 @default.
• W2028408032 cites W2083342601 @default.
• W2028408032 cites W2087461746 @default.
• W2028408032 cites W2127501956 @default.
• W2028408032 cites W2137221862 @default.
• W2028408032 cites W2147064856 @default.
• W2028408032 cites W2154538588 @default.
• W2028408032 cites W2232229242 @default.
• W2028408032 cites W4239139509 @default.
• W2028408032 doi "https://doi.org/10.1016/j.jdcr.2015.02.007" @default.
• W2028408032 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/4808702" @default.
• W2028408032 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/27051700" @default.
• W2028408032 hasPublicationYear "2015" @default.
• W2028408032 type Work @default.
• W2028408032 sameAs 2028408032 @default.
• W2028408032 citedByCount "7" @default.
• W2028408032 countsByYear W20284080322017 @default.
• W2028408032 countsByYear W20284080322018 @default.
• W2028408032 countsByYear W20284080322019 @default.
• W2028408032 countsByYear W20284080322020 @default.
• W2028408032 countsByYear W20284080322021 @default.
• W2028408032 countsByYear W20284080322023 @default.
• W2028408032 crossrefType "journal-article" @default.
• W2028408032 hasAuthorship W2028408032A5017119601 @default.
• W2028408032 hasAuthorship W2028408032A5056847511 @default.
• W2028408032 hasAuthorship W2028408032A5081284457 @default.
• W2028408032 hasBestOaLocation W20284080321 @default.
• W2028408032 hasConcept C159047783 @default.
• W2028408032 hasConcept C16005928 @default.
• W2028408032 hasConcept C203014093 @default.
• W2028408032 hasConcept C2776364478 @default.
• W2028408032 hasConcept C2779609412 @default.
• W2028408032 hasConcept C3013748606 @default.
• W2028408032 hasConcept C71924100 @default.
• W2028408032 hasConceptScore W2028408032C159047783 @default.
• W2028408032 hasConceptScore W2028408032C16005928 @default.
• W2028408032 hasConceptScore W2028408032C203014093 @default.
• W2028408032 hasConceptScore W2028408032C2776364478 @default.
• W2028408032 hasConceptScore W2028408032C2779609412 @default.
• W2028408032 hasConceptScore W2028408032C3013748606 @default.
• W2028408032 hasConceptScore W2028408032C71924100 @default.
• W2028408032 hasIssue "3" @default.
• W2028408032 hasLocation W20284080321 @default.
• W2028408032 hasLocation W20284080322 @default.
• W2028408032 hasLocation W20284080323 @default.
• W2028408032 hasLocation W20284080324 @default.
• W2028408032 hasOpenAccess W2028408032 @default.
• W2028408032 hasPrimaryLocation W20284080321 @default.
• W2028408032 hasRelatedWork W1504143440 @default.
• W2028408032 hasRelatedWork W1534024776 @default.
• W2028408032 hasRelatedWork W2044038262 @default.
• W2028408032 hasRelatedWork W2047989793 @default.
• W2028408032 hasRelatedWork W2351149888 @default.
• W2028408032 hasRelatedWork W2398424343 @default.
• W2028408032 hasRelatedWork W2738981461 @default.
• W2028408032 hasRelatedWork W4234833016 @default.
• W2028408032 hasRelatedWork W4247728950 @default.
• W2028408032 hasRelatedWork W4297184974 @default.
• W2028408032 hasVolume "1" @default.
• W2028408032 isParatext "false" @default.
• W2028408032 isRetracted "false" @default.
• W2028408032 magId "2028408032" @default.
• W2028408032 workType "article" @default.