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

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.
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PMID:Intolerable pruritus in an HIV-infected man. 1136 93

Vaginal candidiasis is an infection caused by a fungus. Normally found in the vagina, it usually has no symptoms but can cause problems when it grows uncontrollably. The infection can be caused by antibiotics or chronic illnesses, such as diabetes or HIV. Symptoms include a white discharge, irritation, and itching which can cause small lesions. A physician can perform a pelvic exam to diagnose candidiasis. Anti-fungal cremes, including nystatin, clotrimazole, micona zole, or suppositories used for one to two weeks can treat candidiasis. Chronic cases may require oral anti-fungal medications. Oral Diflucan is being studied for the prevention of oral and vaginal candidiasis.
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PMID:[Vaginal candidiasis]. 1136 36

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.
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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.
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PMID:Recommendations for the clinical development of topical microbicides: an update. 1139 65

Itching is a common complaint among patients infected with HIV and may cause significant morbidity and embarrassment. Although idiopathic HIV-pruritus has been described, it is probably less common than was previously thought. In most patients, a careful history and physical examination will show that a dermatosis accounts for their pruritus. Dry skin, seborrheic dermatitis, eczema, psoriasis, pruritic papular eruption, staphylococcal folliculitis and prurigo nodularis are frequently encountered in these patients. These common dermatoses, drug eruptions, several rarer conditions and systemic causes of itching should be excluded before diagnosing idiopathic HIV-pruritus. Treatment should be directed to the underlying skin problem and may be supplemented with sedating antihistamines. Phototherapy is a safe and effective therapeutic modality for many pruritic dermatoses as well as for idiopathic pruritus.
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PMID:Evaluation and treatment of itching in HIV-infected patients. 1151 17

Leishmaniasis is a protozoan disease whose clinical manifestations depend both on the infecting species of Leishmania and the immune response of the host. Transmission of the disease occurs by the bite of a sandfly infected with Leishmania parasites. Infection may be restricted to the skin in cutaneous leishmaniasis (CL), to the mucous membranes in mucosal leishmaniasis or spread internally in visceral leishmaniasis (VL). In the last 2 decades, leishmaniasis, especially VL, has been recognized as an opportunistic disease in immunocompromised patients, particularly those infected with HIV. Leishmaniasis is characterized by a spectrum of disease phenotypes that correspond to the strength of the host's cell-mediated immune response. Both susceptible and resistant phenotypes exist within human populations. Clinical cutaneous disease ranges from a few spontaneously-healing lesions, to diffuse external or internal disease, to severe mucous membrane involvement. Spontaneously-healing lesions are associated with positive antigen-specific T cell responsiveness, diffuse cutaneous and visceral disease with T cell non-responsiveness, and mucocutaneous disease with T cell hyperresponsiveness. Current research is focused on determining the extent to which this spectrum of host response is genetically determined. In endemic areas, diagnosis is often made on clinical grounds alone including: small number of lesions; on exposed areas; present for a number of months; resistant to all types of attempted treatments; and usually no pain or itching. Multiple diagnostic techniques are available. When evaluating treatment, the natural history of leishmaniasis must be considered. Lesions of CL heal spontaneously over 1 month to 3 years, while lesions of mucocutaneous and VL rarely, if ever, heal without treatment. Consequently, all the latter patients require treatment. Therapy is not always essential in localized CL, although the majority of such patients are treated. Patients with lesions on the face or other cosmetically important areas are treated to reduce the size of the resultant scar. In addition, the species of parasite should be identified so that infection with Leishmania braziliensis and Leishmania panamensis can be treated to reduce the risk of development of mucocutaneous disease. Treating patients with Leishmania and HIV co-infection requires close monitoring for effectiveness of treatment, especially because of the high relapse rates. Proven treatments include: antimonials, pentamidine, amphotericin B, interferon with antimony. Treatments where current clinical experience is too limited include: allopurinol, ketoconazole, itraconazole, immunotherapy, rifampin, dapsone, localized heat, paromomycin ointment and cryotherapy. Investigational treatments include: WR6026, liposomal amphotericin and miltefosine. In addition, vaccines for leishmaniasis are being investigated in clinical trials.
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PMID:Leishmaniasis: recognition and management with a focus on the immunocompromised patient. 1189 21

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

In vitro studies indicate that an intact female condom effectively prevents sexually transmitted diseases (STDs) and HIV infection, remains impermeable during intercourse, and is more leak resistant than the male latex condom. Most trials in 30 countries show that, with practice, women can easily insert the condom. Women not bothered by touching their genitals and who have experience with male condoms or insertion of objects (e.g., diaphragms) into the vagina report fewer problems with insertion. The rings of the female condom appear to bother both women and their partners. The inner ring caused 30% of women in Thailand to stop using it. 20% of males did not like their penises touching the ring. Prostitutes in France and their patrons removed the inner ring and used it like a male condom. Mexican prostitutes objected to its overly large size, fearing that penises that large would not go into their vaginas. Other users did not like its baggy appearance. Some Mexican women did not like the outer ring being outside the vagina, but after experience, they considered it to be positive since it provides protection and is hygienic. Some infrequent complaints include noisiness, labial itching, and irritation. Sexual pleasure seems to increase with use. More than 50% of trial participants and partners considered the female condom to be acceptable and would use it again. Prostitutes in Mexico and Cameroon were very pleased, mainly because the female condom can protect them against HIV and STDs. Low-income prostitutes and their clients in Thailand appreciated it. Men in developing countries tended to dislike it more than those in developed countries. The female condom will be available for women in the US and in Europe in 1993. It is relatively expensive, and the price should be reduced.
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PMID:The female condom tested. 1231 44


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