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Abnormal Insect Bite Reactions in an HIV-Positive Patient

Purpose: To evaluate an HIV-positive patient with an abnormal insect bite reaction as reported by Ajithkumar et al.

Description

Ajithkumar et al identified HIV-positive patients who showed abnormal insect bite reactions. Sometimes the abnormal skin reaction were the first indication of an underlying HIV infection. The authors are from Medical College Chest Hospital in Trichur and the Christian Medical College Hospital in Vellore, India.


 

Clinical features:

(1) The patient is HIV-positive.

(2) The patient has exaggerated insect bite reactions involving exposed skin.

(3) Most of the patients showed a low CD4 counts (< 400 per µL).

 

The authors hypothesized that the lesions were associated with immunosuppression. In theory the patient had undergone desensitization to insect antigens after multiple bites. With immunosuppression the delayed hypersensitivity reaction could be reactivated.

 

Differential diagnosis:

(1) opportunistic infection

(2) scabies

(3) other pruritic papular eruptions associated with HIV

(4) CLL or other lymphoproliferative disorder

 


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Specialty

Objective

ICD-10