Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In parenteral drug abuse, cutaneous manifestations are very common. A variety of skin lesions are indicators of a possible drug addiction: obliteration of peripheral veins and hyperpigmentation of the overlying skin, punched-out scars due to subcutaneous injection, persistent edema following thrombophlebitis, and excoriations due to heroin pruritus. Infectious and non-infectious complications may be accompanied by typical skin alterations, such as ecthyma in sepsis caused by Pseudomonas aeruginosa, multiple ulcers due to embolic infarct, or hypersensitivity reactions mediated by an immunological process. A variety of serious complications may develop at the injection sites: abscesses, gangrene, necrosis, or necrotizing fasciitis. These examples show that the dermatologist is in many ways involved in the care for addicted patients. In addition, these patients frequently suffer from sexually transmitted diseases or blood-borne infections; HIV-infection is rapidly spreading in this group. We now face new problems of differential diagnosis, especially since constitutional symptoms of HIV-infection may mimic symptoms of drug abuse and vice versa. Moreover, immunological alterations similar to those in HIV patients may even occur in drug addicts who are not infected with the virus.
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PMID:[Skin changes in drug-dependent patients]. 219 89

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

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

A 65-year-old man with insulin-dependent diabetes developed intractable pruritus preceding weight loss and increasing fatiguability. Esophagogastroduodenoscopy revealed infection with Candida, cytomegalovirus, and Cryptosporidium. His T cell helper/suppressor ratio was inverted, and the serum human immunodeficiency virus (HIV) antibody was positive. Results of an extensive evaluation for internal malignancy were negative. Despite optimal care, the patient died 12 weeks after his initial hospitalization. We believe that HIV infection should be added to the list of underlying disorders that may present with pruritus.
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PMID:Pruritus as a presenting sign of acquired immunodeficiency syndrome. 358 90

The main aspects of the acquired immunodeficiency syndrome (AIDS) epidemic in Africa as of mid-1986 are discussed. In certain parts of Africa the disease appears to be widespread and fairly evenly divided between the sexes. Most of the AIDS patients have traveled a great deal and been very active sexually, even while traveling. Prostitutes in such large cities as Nairobi are heavily infected with HIV. Recognized routes of infection are: sexual transmission, blood transfusion, contaminated injection equipment, and mother to child. The pathology of AIDS involves the death of the helper cell type of T-lymphocytes, which increases the patient's susceptibility to infections and tumors. There is some evidence that the HIV epidemic originated in central Africa, possibly as a mutant of the green monkey fever virus, and gradually spread to Europe and the USA. Clinically, AIDS should be suspected with such symptoms as persistent unexplained fever, chronic diarrhea, lymphadenopathy, severe wasting, and itching skin lesions, primarily on the extremities. Definitive symptoms include such opportunistic infections as candida esophagii, cryptococcus, severe varieties of herpes simplex, pneumocystis carinii pneumonii, disseminated strongyloids, cerebral toxoplasmosis and a typical mycobacteria. Serological diagnostic tests include enzyme linked immunosorbent assay (ELISA) and Western blot, both of which require advanced equipment. No treatment for AIDS is known; management should concentrate on preventing opportunistic infection.
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PMID:[AIDS in Africa]. 364 40

We report 15 cases of symptomatic HIV infection seen in Paris between June 1983 and June 1985 in Congolese patients. The first signs were diarrhea, weight loss, fever, pruritus. Disseminated lymphadenopathy was frequent. Twelve patients had AIDS, and the opportunistic infections were: isosporosis, oesophageal candidiasis, cerebral toxoplasmosis, Kaposi's sarcoma, CNS' cryptococcosis, cutaneo-mucosal.
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PMID:[Clinical and biological consequences of human immunodeficiency virus (LAV) infection in 15 Congolese subjects]. 364 75

We describe the case of a young man of Calabrian origin, who came to our observation for the appearance of erythematous pustular, intensely itching, lesions on the arms, trunk and, in a less extent, on the face. The blood count revealed a differential cell count of 16.8% eosinophils. Serum IgE levels were elevated (1000 IU/ml), and T cell subsets showed an increase in CD8+ and a decrease in CD4+ with an inversion of CD4+/CD8+ ratio (= 0.78). The result of the following investigations were either normal or negative: anti-(ds)DNA antibody, anti-nuclear antibody, anti-smooth muscle antibody, anti-striated muscle antibody, serological tests for viral, bacterial, fungal and parasitic diseases and cultural examination of the material from lesion. Histopathological examination of a biopsy specimen from the left arm showed the presence of abundant perivascular inflammatory infiltrate in the dermis and inflammatory infiltrate, with numerous eosinophils, around sebaceous glands. Taken together, all these data suggest the diagnosis of eosinophilic pustular folliculitis, a dermatosis of unknown etiology, with a histopathological picture identical to Ofuji's disease. Eosinophilic pustular folliculitis can be associated with HIV infection or haematological diseases (as non-Hodgkin lymphomas, myeloma, etc.); it was also reported in adult immunocompetent healthy individuals and in children. On the basis of our findings, we propose that this case should be classified as an idiopathic form, as we were not able to demonstrate any associated disease.
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PMID:[Eosinophilic pustular folliculitis and Ofuji disease. A case report]. 750 2

Acquired immunodeficiency syndrome was first recognized as a new disease in 1981 because of the unusual association of Kaposi's sarcoma and Pneumocystis carinii pneumonia in young men. The skin remains one of the most important clinical markers for acquired immunodeficiency syndrome, now recognized as the end stage of infection with the human immunodeficiency virus (HIV). Indeed, an urticarial viral exanthem appearing during seroconversion may allow early identification of newly infected individuals who might benefit from administration of antiviral therapy during plasma viremia. The "asymptomatic HIV infection" is often accompanied by multiple skin complaints, which commonly include xerosis, pruritus, psoriasis/seborrheic dermatitis, and pruritic papular eruptions, the cause of which remains controversial. Psoriasis and Kaposi's sarcoma lesions share features including angiogenesis, dermal dendrocytes infected with HIV, and epidermal hyperproliferation, and are manifested by mice transgenic for HIV provirus or Tat-ltr. Changes in the immune system including T-cell function, antigen response, and shifting cytokine expression as well as a propensity for autoimmune reactions must underlie the skin immunodysfunction occurring in the setting of HIV infection. One of the most unsettling controversies suggested by in vitro data is that ultraviolet light, an effective therapy for HIV-related skin disorders, may actually activate the virus.
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PMID:Human immunodeficiency virus and the skin: selected controversies. 761 89

A 63-year-old, Dutch, HIV-seronegative man presented with anal pain and itch of 6 months' duration, a perianal ulcer and a solitary colon ulcer. Crohn's disease was suspected; the patient was treated with corticosteroids, but later died. Autopsy revealed disseminated histoplasmosis, a fungal disease rare in the Netherlands. The patient had visited Honduras. This case report illustrates that disseminated histoplasmosis may mimic Crohn's disease leading to a delay in the diagnosis.
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PMID:[Generalized histoplasmosis due to endogenous reactivation of a latent infection in an HIV-seronegative man]. 762 32

An exploratory study was conducted in Malawi to determine whether a correlation exists between human immunodeficiency virus (HIV) and traditional practices involving the intravaginal application of substances such as herbs and pulverized stone. Included in the survey were 6603 consecutive consenting volunteers who presented at the prenatal clinic of an urban hospital from October 1989-October 1990. The median age of study participants was 24 years. Although only 11% reported having had a sexually transmitted disease (STD) in the three years preceding the interview, laboratory analysis revealed the presence of such an infection in 46%. HIV infection was found in 1502 (23%). A total of 2953 (45%) of these pregnant women reported use of vaginal agents or vaginal incision, either for the treatment of discharge or itching or for the enhancement of sexual pleasure through vaginal tightening. Concerns have been raised that the placement of desiccants, irritants, and astringents in the vagina can induce certain physiological changes that increase the risk of HIV infection. Demonstrated in this survey was a slight association between HIV seropositivity and the use of vaginal agents for self-medication but not for vaginal tightening. In the univariate analysis, this finding persisted only for pregnant women without past or current STD infection. In the multivariate analysis, users of vaginal agents for treatment had a small increased risk of HIV in addition to--and independently of--the risk conferred by an STD history. It is possible, however, that the use of vaginal agents for self-medication is a marker for the presence of genital tract inflammation--a co-factor for HIV transmission. Given the extent of this traditional practice and its potential risk, more research is urged on the type of vaginal agents used and their effects on vaginal tissue.
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PMID:Traditional vaginal agents: use and association with HIV infection in Malawian women. 775 19


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