title: Antihistamines are superior to topical steroids in managing human immunodeficiency virus (HIV)-associated papular pruritic eruption.
abstract: Papular pruritic eruption (PPE) is a frequent HIV-comorbidity in tropical countries. Because of constant itching and social stigma, effective treatment is highly valued. In our HIV cohort in rural Tanzania with 12% prevalence of PPE, we have retrospectively analyzed responses to available treatments. Oral promethazine improved itching (P < 0.0058) and clinical scores (P < 0.032) significantly more than topical steroids. Disease activity did not correlate with CD4+ and CD8+ T cell counts and was independent of anti-retroviral medication. Therefore, oral antihistamines are an effective first-line treatment for PPE.
authors.affiliation: Ifakara Health Institute, Ifakara, Kilombero, Tanzania. alexander.navarini@usz.ch
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Navarini
authors.forename: Marcel
authors.initials: M
authors.lastname: Stoeckle
authors.forename: Susanne
authors.initials: S
authors.lastname: Navarini
authors.forename: Erik
authors.initials: E
authors.lastname: Mossdorf
authors.forename: Boniphace S
authors.initials: BS
authors.lastname: Jullu
authors.forename: Rehema
authors.initials: R
authors.lastname: Mchomvu
authors.forename: Marco
authors.initials: M
authors.lastname: Mbata
authors.forename: Patience
authors.initials: P
authors.lastname: Kibatala
authors.forename: Marcel
authors.initials: M
authors.lastname: Tanner
authors.forename: Christoph
authors.initials: C
authors.lastname: Hatz
authors.forename: Peter
authors.initials: P
authors.lastname: Schmid-Grendelmeier
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D023241:Antiretroviral Therapy, Highly Active; D016516:CD4-CD8 Ratio; D005076:Exanthema / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006633:Histamine Antagonists / Q000008:administration & dosage*; D006634:Histamine H1 Antagonists / Q000008:administration & dosage; D006801:Humans; D011398:Promethazine / Q000008:administration & dosage; D011537:Pruritus / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D012189:Retrospective Studies; D013256:Steroids / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D013636:Tanzania; D016896:Treatment Outcome
chemical_list: D006633:Histamine Antagonists; D006634:Histamine H1 Antagonists; D013256:Steroids; D011398:Promethazine