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HIV papular pruritic eruption — DTM&H MCQ

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ModerateHIV in TropicsHIV papular pruritic eruptionDTM&H

A 18-year-old man in sub-Saharan Africa presents with papular pruritic eruption, generalised lymphadenopathy, and weight loss. His CD4 count is 280 cells/µL. What is the most likely cause of the skin lesions?

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Correct answer: E — HIV-associated papular pruritic eruption

Papular pruritic eruption (PPE) is one of the most common dermatological manifestations of HIV in sub-Saharan Africa. It presents as chronic, intensely pruritic papules on the trunk and extremities. It occurs at CD4 counts typically 200-500 and improves with ART-mediated immune reconstitution. Secondary syphilis causes non-pruritic papules. Scabies shows burrows and interdigital involvement. PPE is a WHO clinical stage 2 condition.

Reference: WHO HIV Staging; Manson's Tropical Diseases