Publication:

Prurigo as the early sign of HIV infection: a review

Prurigo is a common dermatological condition in HIV-infected individuals, particularly those with low CD4 counts. This condition can be the first manifestation and as the early sign of HIV-infected individuals. One form of prurigo in HIV-positive patients is prurigo nodularis. It presents with intensely pruritic, hyperkeratotic papules or nodules lesions, significantly impairing quality of life. The pathogenesis of PN involves complex immune dysregulation, including Th2-mediated inflammation and the release of cytokines like IL-31, which contribute to inflammation and pruritus. HIV infection exacerbates these processes, making PN more prevalent and severe in immunocompromised individuals. Early detection of prurigo and appropriate treatment, including rapid antiretroviral therapy, can help reduce the frequency and severity of prurigo in HIV-positive patients. Current treatments include topical steroids, UV therapy and systemic medications, with novel therapies targeting specific cytokines under investigation. Dermatologists are also encouraged to screen for psychiatric comorbidities due to the profound psychosocial impact of PN. This review aims especially for health workers to remind the importance of early detection of dermatological signs of prurigo in patients at risk of HIV, as an important step in improving clinical outcomes and patient quality of life.