Pruritic papular eruption and eosinophilic folliculitis associated with human immunodeficiency virus (HIV) infection: A histopathological and immunohistochemical comparative study - 13/07/12
, Nilceo Schwery Michalany, MD, PhD b, Suely Nonogaki, PhD c, Adriana Maria Porro, MD, PhD a
Correspondence to: Jane Tomimori, MD, PhD, Department of Dermatology, Federal University of São Paulo (UNIFESP), Rua Botucatu, 740 CEP: 04023-900 São Paulo/SP Brazil.Abstract |
Background |
Among the papular-pruriginous dermatoses related to human immunodeficiency (HIV) infection, two entities remain poorly differentiated leading to confusion in their diagnosis: HIV-related pruritic papular eruption (HIV-PPE or prurigo) and eosinophilic folliculitis (HIV-EF).
Objective |
To establish histopathological and immunohistochemical parameters to differentiate between two conditions associated with HIV infection, the pruritic papular eruption (HIV-PPE) and eosinophilic folliculitis (HIV-EF).
Methods |
Clinically typical HIV-PPE (18 cases) and HIV-EF (10 cases) cases were compared with each other in terms of the following topics: clinical and laboratory features (gender, age, CD4+ cell and eosinophil count), histopathological features (hematoxylin-eosin and toluidine blue staining) and immunohistochemical features (anti-CD1a, anti-CD4, anti-CD7, anti-CD8, anti-CD15, anti-CD20, anti-CD30, anti-CD68/macrophage and anti-S-100 reactions).
Results |
Among the HIV-EF patients, we found an intense perivascular and diffuse inflammatory infiltration compared with those patients with HIV-PPE. The tissue mast cell count by toluidine staining was higher in the HIV-EF patients, who also presented higher expression levels of CD15 (for eosinophils), CD4 (T helper), and CD7 (pan-T lymphocytes) than the HIV-PPE patients.
Limitations |
Only quantitative differences and not qualitative differences were found.
Conclusions |
These data indicate that HIV-related PPE and EF could possibly be differentiated by histopathological and immunohistochemical findings in addition to clinical characteristics. In fact, these two inflammatory manifestations could be within the spectrum of the same disease because only quantitative, and not qualitative, differences were found.
Le texte complet de cet article est disponible en PDF.Key words : eosinophilic folliculitis, histopathological, HIV, immunohistochemical, prurigo, pruritic papular eruption
Abbreviations used : EF, HAART, HIV, IRIS, PPE
Plan
| The first two authors contributed equally to this work and are both first authors. |
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| Supported by FAPESP-Fundação de Apoio a Pesquisa do Estado de São Paulo (Foundation for Research Support of São Paulo’s State). |
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| Conflicts of interest: None declared. |
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| This work was submitted and approved by the Federal University of São Paulo’s Ethics Committee in accordance with the Helsinki Declaration of 1975, as revised in 1983. |
Vol 67 - N° 2
P. 269-275 - août 2012 Retour au numéro
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