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

To determine whether common skin diseases associated with human immunodeficiency virus (HIV) were distinguishable based on the pattern of serum cytokine expression, we studied patients with psoriasis, pruritus, and Kaposi's sarcoma (KS) for levels of tumor necrosis factor (TNF)-alpha, interferon-gamma (IFN-y), interleukin (IL)-10, and IL-4. Thirty-two HIV-positive (HIV+) patients including 8 with KS, 11 with psoriasis, and 13 with pruritus along with 16 HIV-negative subjects with psoriasis were studied. IFN-gamma levels were highest in sera of HIV+ patients with psoriasis (p = 0.040). By contrast, TNF-alpha and IL-10 levels were highest in sera of HIV+ patients with pruritus (p = 0.012). Detectable levels of all cytokines in these patients were remarkably higher than for healthy adults. These results suggest that common skin diseases associated with HIV infection and AIDS can be distinguished by the production of unique cytokines.
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PMID:Distinct serum cytokines in AIDS-related skin diseases. 1018 88

AIDS is known to cause a shift of cytokines in the periphery. However, predominant cytokines in skin of patients with HIV-associated skin diseases have not been clearly defined. We hypothesized that there are distinct cytokine profiles that distinguish among the different clinical manifestations of AIDS-related skin diseases. To test this hypothesis, lesional and non-lesional skin was biopsied from 53 HIV+ patients with Kaposi's sarcoma (KS), psoriasis, and pruritus due to eosinophilic folliculitis, and from HIV negative controls with psoriasis or KS prior to therapy. Immunohistochemistry was performed with antibodies to tumor necrosis factor (TNF)-alpha, interleukin (IL)-10, interferon (IFN)-gamma, and interferon-inducible protein (IP)-10. HIV positive individuals included 10 with psoriasis, 14 with pruritus, and 15 with Kaposi's sarcoma. HIV negative controls included 12 with psoriasis and two with KS. Semi-quantitative analysis of cytokine staining was confirmed by optical density using a digital imaging system on four representative skin sections from each disease. Optical density analyses were conducted using ANOVA and t-tests. We found that epidermis overlying HIV+ Kaposi's sarcoma was hyperproliferative and was highest in IP-10, IFN-gamma, and IL-10 (P=0.0001). HIV+ pruritus was significantly highest in TNF-alpha (P=0.0001) staining. HIV+ psoriasis represented an intermediate state for all four cytokines. Normal skin adjacent to lesions showed the same relative patterns, with lower intensities. Skin diseases seen frequently in the setting of HIV and immunodeficiency have relatively distinct levels and patterns of cytokine expression that may reflect immune dysfunction, reactivity to HIV and to opportunistic infections.
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PMID:Cytokine expression patterns distinguish HIV associated skin diseases. 1101 55

We present a 35-year-old patient with acquired immunodeficiency syndrome who had demodicidosis on his face, characterized by multiple papules and papulopustules, associated pruritus, numerous mites on skin-surface biopsy and in biopsy specimens, and rapid response to topical treatment with permethrin. It seems likely that Demodex infestation does not manifest unless local or systemic immune function is altered, leading to the proliferation of the organism and subsequent disease.
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PMID:Rosacea-like demodicidosis associated with acquired immunodeficiency syndrome. 1116 95

This dose-escalation study was performed to evaluate safety and efficacy of imiquimod 5% cream in the treatment of uncircumcised men with penile warts associated with the foreskin. The cream was applied 3 times/week (n=34) or once per day (n=30) over 8+/-2 h. Imiquimod 5% cream was safe in both treatment groups. However, the 3 times/week regimen was better tolerated with a lower incidence of local skin reactions. In both groups, the 2 most frequently reported local skin reactions were erythema and erosion; they were more severe with the once-daily dosing. The most frequently reported application site reactions were burning, pruritus and irritation or pain (once-daily patients only). Total clearance was achieved in 62% of the patients in the 3 times/week group and by 57% in the once-daily group. Thus, imiquimod 5% cream administered 3 times/week was the optimal dosing regimen in the treatment of penile warts in uncircumcised men.
Int J STD AIDS 2001 Jan
PMID:Safety and efficacy of imiquimod 5% cream in the treatment of penile genital warts in uncircumcised men when applied three times weekly or once per day. 1180 42

Nine out of ten HIV-infected people suffer from dermatologic complaints. Frequently, the morphology of HIV-associated skin lesions is characteristic enough for the clinician to construct an initial diagnosis and initiate a reasonable course of treatment until the diagnosis can be confirmed. However, HIV-associated pruritus can be difficult to diagnose and control. A debilitating itch could indicate eosinophilic, staphylococcal, or idiopathic folliculitis; "severe generalisata" characteristic of HIV infection; a drug allergy; severe HIV-related dermatophyte infection; or scabies. Scabies, frequently overlooked as a cause of severe pruritus in HIV infection, manifests atypically in HIV-infected individuals. Its spectrum ranges from pruritus with minimal or no cutaneous signs to the widespread, thick, crusted plaques called "crusted" or "Norwegian" scabies. Diagnosis requires microscopic inspection of a skin scraping or a biopsy, though response to empiric treatment with antimite agents may also be diagnostic. The frequent need for repeated courses of antimite medication in cases with large mite loads and hyperkeratotic lesions may, however, preclude accurate diagnosis via empiric treatment.
AIDS Clin Care 1995 Mar
PMID:Intolerable pruritus in an HIV-infected man. 1136 93

People with HIV/AIDS often develop hypersensitivity to certain drugs, particularly Nevirapine (Viramune). This drug causes reactions, including a rash, in more than 33 percent of people who use it. A life-threatening rash, known as Stevens-Johnson syndrome, occurs in 1 percent of patients using Nevirapine. Doctors in France conducted a desensitization program on three subjects who developed rash or hives, high fever, swollen eyes and painful muscles after starting the medication. Patients were given gradually increasing doses of Nevirapine and monitored for reactions. Two subjects developed mild itching, which cleared up after receiving Allegra; the third subject did not respond to the treatment.
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PMID:Desensitization to Nevirapine. 1136 44

Itchy skin rashes, pruritus, are common in people with HIV infection. Pruritus is associated with HIV-induced immunosuppression, opportunistic infections, cancer, or other illness. Most conditions can be successfully treated when diagnosed. The most common causes of itchy skin include scabies and other insect bites, inflamed hair follicles, drug reactions, scaly skin disorders, and photosensitivity dermatitis. Each of these conditions is described and treatments are suggested.
Newsline People AIDS Coalit N Y 1998 Mar
PMID:Itchy skin in HIV. 1136 52

Topical microbicides are products that are being developed to prevent HIV infection and other sexually transmitted diseases (STD) through topical application to the genital and rectal epithelial surfaces. This paper is an update of the clinical section of a general guidance for the development and evaluation of microbicidal products that was first published by the International Working Group on Microbicides (IWGM) in 1996. (The preclinical section of that document will be updated separately later.) All topical microbicides should be clinically evaluated in humans for safety and effectiveness. Safety studies are necessary to evaluate the potential for systemic absorption and toxicity as well as local toxic effects, such as irritation, ulceration, burning, and itching. Reported symptoms of burning and itching are relevant to future product use and acceptability. Irritation and ulceration of the vaginal, cervical, penile, or rectal epithelium have the potential to result in an increased transmission of HIV and other STD. Effectiveness studies to assess the prevention of HIV infection or STD, depending upon the product indication, are subsequently conducted. These trials need to be large enough to detect clinically meaningful levels of protection. For spermicidal microbicides, additional contraceptive effectiveness studies are also needed.
AIDS 2001 May 04
PMID:Recommendations for the clinical development of topical microbicides: an update. 1139 65

Pruritus, or generalized itch, is a source of serious discomfort and distress in a significant minority of people living with AIDS. Anecdotal reports suggest hypnosis might be a useful treatment, leading to reductions in distress and improvements in the condition. But empirical examination of the question is notably lacking. This time-series study reports results of a 6-session self-hypnosis treatment (relaxation, deepening, imagery, and home practice) for 3 HIV-positive men suffering from pruritus, related to disease progression and/or HIV medications. Posttreatment, all 3 patients reported significant reductions in daily itch severity and extent of sleep disturbance due to itch. One patient also evidenced significantly less itch distress. Another also experienced significantly less time bothered by itch. For the 2 patients on which 4-month follow-up data were available, treatment benefit across variables was stable or further improved.
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PMID:The efficacy of hypnosis in the treatment of pruritus in people with HIV/AIDS: a time-series analysis. 1193 76

Latex, a material derived from the rubber tree, can cause an allergic reaction in the form of contact dermatitis. This allergy can manifest in a rash, swelling, and itching, and symptoms can be mild or severe. Individuals who come into frequent contact with latex are at risk of developing an allergy. Latex allergy should be suspected in cases of swelling or itching after a medical examination, contact with rubber gloves, swelling or itching of the mouth and lips after blowing up a balloon or having a dental examination, or oral itching after eating bananas, chestnuts, or avocados. Latex sensitivity can cause penile, vaginal, or rectal itching or swelling after using male condoms or a vaginal diaphragm. People with latex allergies can use lambskin condoms (which protect against pregnancy but not against sexually transmitted diseases [STDs]) or polyurethane condoms. The female condom, Reality, is made of polyurethane and protects against pregnancy, STDs, and HIV/AIDS. The male polyurethane condom, Avanti, will be available nationwide in the US in 1997. Additional research is required to determine if the male polyurethane condom protects against STDs as well as pregnancy.
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PMID:Latex allergy and contraception. 1229 Mar 48


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