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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bullous pemphigoid (BP)-type autoantibodies were found by Western blot (WB) analysis of epidermal extracts in the serum of 38% of HIV-seropositive patients compared with 21% of HIV-seronegative patients with chronic pruritus and 76% of patients with BP. They were further identified as BP autoantibodies (BPab) by immunoprecipitation and immunoelectron microscopy. Their incidence increased from 21% in HIV infection stage II to 37% and 43% in stages III and IV, respectively. Of the patients suffering from HIV-related chronic pruritic papulovesicular eruption. 75% showed circulating BPab as compared with 29% in those without skin problems (P = 0.0066) and, among them, 30% met the diagnostic criteria for BP when histology, WB, immunofluorescence and immunoelectron microscopy techniques were used. In conclusion, this study identifies an autoimmune skin reaction that may account for, or be related to, the distressing pruritic eruptions occurring in HIV-infected patients.
AIDS 1991 Apr
PMID:Bullous pemphigoid autoantibodies, HIV-1 infection and pruritic papular eruption. 205 88

A total of 100 heterosexual adults of either sex with frequent episodes of recurrent genital herpes were allocated to treatment with either Genivir (DIP-253) 1% cream or placebo cream. All patients had genital herpes previously verified by a positive viral culture. The study was carried out as a double-blind parallel group trial. Fifty patients were allocated to each of the two treatment groups. The treatment was initiated within 24 hours after the first sign of a recurrence, and at the pretreatment examination all patients had developed typical lesions with blisters and/or sores. At baseline a sample for herpes virus culture and typing was obtained. The creams were applied four times daily for five days. Follow-up examinations were carried out on days 1, 2, 4 and if needed on days 7, 10 and 14. The major factor used for assessment of efficacy was the time to complete healing of all lesions. Duration of pruritus and pain were also recorded. In the group of patients treated with Genivir cream the time to complete healing was 3.3 days and in the placebo group 6.1 days. The difference was statistically significant (P less than 0.001). The mean duration of pain was 1.3 days in the Genivir group and 2.5 days in the placebo group: this difference also reached significance (P less than 0.01). The duration of pruritus was about the same in both groups. The active agent in Genivir, DIP-253, is a heterocyclic aromatic complex with confirmed anti-herpetic activity and with evidence of a local immunomodulatory effect. It was concluded that the efficacy of topical application of DIP-253 may be due to combined antiviral and immunomodulatory activities.
Int J STD AIDS 1990 Jan
PMID:Genivir (DIP-253) 1% cream versus placebo cream in the treatment of recurrent genital herpes: a double-blind study. 209 94

Trimetrexate is a nonclassical antifol currently being tested for efficacy in cancer patients and as an antiparasitic agent against Pneumocystis carinii pneumonia in AIDS patients. We have now received the first reports of hypersensitivity reactions in Phase II cancer trials. Two types of reactions were noted. The most severe reaction, immediate hypotension with loss of consciousness, occurred in only one patient. Four other patients exhibited an immediate systemic effect with one or more of the following symptoms: facial flushing, fever, shaking, pruritus, bronchospasm, periorbital edema, and difficulty in swallowing. Immediate hypersensitivity should now be considered a known side effect of trimetrexate therapy, occurring in less than 2% of patients.
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PMID:Hypersensitivity reactions to trimetrexate. 214 1

Diffuse dermatitis and markedly elevated serum IgE concentrations were observed in three adult males who were seropositive for human immunodeficiency virus (HIV) antibody. The clinical features in common for these patients included 1) an adult onset of greater than 6 weeks' duration associated with pruritus, 2) T-helper (CD-4) cell depletion, 3) the lack of overt atopic disease, and 4) the lack of opportunistic infection (except oral thrush) and neoplasia. The mean serum IgE concentration was 5,959 (range: 4,930-6,260) IU/ml. Cutaneous involvement consisted of hyperpigmented papules with variable excoriations and lichenification. Zidovudine was administered to all 3 patients and was associated with cutaneous improvement. Serum IgE concentrations from 19 AIDS patients without cutaneous disease did not show significant elevations. These observations suggest that certain patients with HIV infection can manifest a unique hyper-IgE syndrome associated with diffuse cutaneous disease.
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PMID:Chronic diffuse dermatitis and hyper-IgE in HIV infection. 246 86

Five of seven patients with acquired immunodeficiency syndrome (AIDS) who had pruritus and a chronic, nonspecific-appearing skin eruption had increased antibody titers to antigens in the salivary glands of Aedes taeniorhynchus, a salt marsh mosquito common to South Florida. We hypothesize that the pruritus and skin lesions in patients with AIDS represent a form of chronic "recall" reaction. Increased antibody titers to mosquito salivary gland antigens may be a consequence of nonspecific B cell activation, a feature of AIDS.
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PMID:Chronic pruritic eruption in patients with acquired immunodeficiency syndrome associated with increased antibody titers to mosquito salivary gland antigens. 256

Cutaneous manifestations of AIDS in the 1st 91 cases diagnosed in French Guiana between 1982-October 1987 included 40 cases of candidiasis, 29 of prurigo, 13 of herpes simplex, 5 of trichomoniasis, 7 of human papilloma virus, 3 of shingles, 3 of donovanoses, and 1 of Kaposi's sarcoma. There were also 7 cases of seborrheic dermatitis, 6 of capillary dystrophies, and 1 of leucoplasia. 26 of the 40 cases of candidiasis were buccal or buccopharyngeal and 14 were vaginal. Such infections are intense, chronic, and easy to diagnose. Local treatment with Nystatin or Amphotericin B in solution for buccal cases and with imidazole derivatives for vaginal cases should be supplemented with systemic medications such as ketoconazole. Most herpes simplex cases are type 2 genital infections which may be chronic and extensive. A perfusion of Aciclovir usually gives good results in 5 or 6 days. Shingles during AIDS often has nonthoracic localizations; involves itching, pain, and burning sensations; is recurrent, perhaps on the contralateral side; and may leave scars. Sensitivity to Aciclovir is less than for herpes simplex. Human papilloma virus lesions that are not too large are treated locally. Although tuberculosis is in 2nd place after candidiasis among opportunistic infections in AIDS patients in French Guiana. Only 2 cases of cutaneous tuberculosis were observed. 3 cases of Donovanosis due to Calymmatobacterium granulomatis were observed, with 2 cases with 1 couple. Chronic prurigo has been observed frequently in AIDS patients in Africa and Haiti. Along with asthenia, polyadenopathies, and shingles, it is often an early sign of AIDS. The pruritus becomes more and more intense and the only treatment providing some relief is local corticotherapy. The dermatovenereal signs of AIDS in tropical environments should raise suspicions of the disease in undiagnosed cases, and they also provide an explanation for the high rate of heterosexual transmission in individuals with various disorders involving genital lesions. Some dermatological disorders common in French Guiana have not been observed in AIDS patients to date.
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PMID:[Infection by the human immunodeficiency virus (HIV) in French Guyana. Dermato-venereologic problems]. 272 41

212 adults with symptomatology indicative of acquired immunodeficiency syndrome (AIDS) presented to the Ivory Coast's Dabou Hospital between January-November 1987. 163 were males and 49 were females; the majority (151) were from rural areas. In terms of the clinical profile, 99% had experienced severe weight loss (greater than 10% of body weight), 43% had generalized pruritus, 66% reported fever exceeding 1 month's duration, 75% reported diarrhea exceeding 1 month's duration, 55% had experienced coughing for longer than 1 month, and 56% demonstrated generalized adenopathies. 128 (60%) of these 212 individuals were positive for antibodies to human immunodeficiency virus (HIV)-1, 15 (7%) were HIV-2 positive, 61 (29%) were seropositive for both HIV-1 and HIV-2, and 8 (4%) were negative for both viruses. Clinical follow-up was possible in 173 of these cases. After 6 months, those infected with HIV-1 manifested 16 unfavorable outcomes (deterioration or death) and 11 favorable outcomes (stable or improved condition). Among those infected with HIV-2, there were no unfavorable and 4 favorable cases. The group positive for HIV-1 and HIV-2 exhibited a clinical course at 6 months similar to that found among the HIV-1 seropositives: 11 unfavorable and 9 favorable outcomes. The data from the Dabou hospital attest to a steady rise in AIDS detection, from 0.21% of all adult outpatient cases in the 1st quarter of 1987 to 1.03% of cases in the last quarter. Although data from this series suggest a milder evolution for HIV-2 associated cases, a clinical follow-up of individuals seropositive for HIV-1 or HIV-2, over a 2-year period, is underway to confirm whether there is indeed a distinct symptomatology and disease pattern for each viral infection.
AIDS 1988 Dec
PMID:Clinical experience of AIDS in relation to HIV-1 and HIV-2 infection in a rural hospital in Ivory Coast, West Africa. 285 51

Enteric infection with the protozoan Isospora belli is common in patients with the acquired immunodeficiency syndrome (AIDS) and causes severe diarrhea. I. belli responds well to treatment with trimethoprim-sulfamethoxazole, but there is a high rate of recurrence. To investigate the effect of long-term prophylaxis, we studied 32 Haitian patients with AIDS complicated by I. belli infection and chronic diarrhea. All were treated with trimethoprim (160 mg) and sulfamethoxazole (800 mg), given orally four times a day for 10 days; the patients were then randomly assigned to receive 500 mg of sulfadoxine and 25 mg of pyrimethamine weekly, 160 mg of trimethoprim and 800 mg of sulfamethoxazole three times a week, or placebo. Half of the patients (5 of 10) who received placebo had recurrent, symptomatic isosporiasis a mean of 1.6 months after the initial treatment. All 22 patients who received either trimethoprim-sulfamethoxazole or sulfadoxine-pyrimethamine remained asymptomatic. I. belli was identified in the stools of only one of these patients, who was receiving trimethoprim-sulfamethoxazole. The study medications were generally well tolerated but had to be discontinued in the cases of two patients because of severe pruritus. In 10 patients, the prophylactic regimen has been continued for a mean of 16 months without recurrent isosporiasis. We conclude that isosporiasis in patients with AIDS can be treated effectively with a 10-day course of trimethoprim-sulfamethoxazole and that recurrent disease can subsequently be prevented by ongoing prophylaxis with either trimethoprim-sulfamethoxazole or sulfadoxine-pyrimethamine.
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PMID:Treatment and prophylaxis of Isospora belli infection in patients with the acquired immunodeficiency syndrome. 229 30

The HIV epidemic probably arose in Africa at about the same time as in the West, and there is a significant seroprevalence of HIV in the central African region. However, the epidemiology and clinical course of AIDS are different in Africa and in the West. In Africa males are infected as often as females, and the commonest means of transmission is heterosexual intercourse. Many HIV-infected people are symptomless, but many others present with or progress to generalized lymphadenopathy, pruritus, herpes zoster, herpes simplex, cellulitis, and oral candidiasis. The World Health Organization developed a clinical case-definition of AIDS in Africa, which was found to have a specificity of 90% and a sensitivity of 59% when tested in Zaire. The Kaposi's sarcoma seen in African AIDS patients is more aggressive than that seen in the West and is often visceral. Gastrointestinal AIDS (the "slim" disease) with weight loss and diarrhea is common in Africa, as are oral and esophageal candidiasis. In Africa Pneumocystis carinii pneumonia is rare, but pulmonary tuberculosis is common. Neurological manifestations include cerebral toxoplasmosis, cytomegalovirus infection, headache, and terminal encephalopathy. About 60% of infants born to seropositive women are infected and die within the 1st year of life. Lack of drugs and diagnostic facilities make both diagnosis and treatment of opportunistic infections difficult.
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PMID:Clinical aspects of HIV infection in developing countries. 305 40

Condom sales rose in the 1980s because condoms protect against the spread of sexually transmitted diseases and AIDS. In anticipation of corresponding increase in the incidence of condom dermatitis, a dermatologist prepared a brief overview of the condition and ways to treat it to prepare health professional for the anticipated increase. In men, allergic reactions may consist of edema of the penis, especially the prepuce; penile itching; and eczematous dermatitis which extends to the scrotum, inguinal areas, and the inner thighs. Symptoms in women vary and may include pubic and groin dermatitis, vulvitis, pruritus vulvae, a burning vaginal sensation, vulval redness and edema, and eczema on nearby skin. Antioxidants or accelerators in the rubber are generally responsible for condom dermatitis. When a health professional believes the dermatitis to be allergic rubber condom dermatitis, he/she should request patch tests for the same make of condom that came in contact with the patient and for rubber chemicals known to induce an allergic reaction, e.g., mercaptobenzothiazole (MBT). To assist, the dermatologist includes a patch test series for such allergens. Natural latex condoms and condoms made of processed sheep intestine cecum may prevent most allergic reactions. Sometimes patients are allergic to condom lubricants, and not the rubber itself. Health professionals must be sure to inform dermatitis patients allergic to the lubricant to not switch to oils or petroleum jelly because they destroy the rubber. Spermicidal contraceptive agents also can cause contact dermatitis, particularly nonoxynol 9. A condom with corn starch can produce urticaria. Further, paralyzed male patients are especially prone to allergic dermatitis from either the rubber in the condom urinals and/or the medical adhesive.
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PMID:Condom dermatitis in either partner. 358


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