Analysis of serum chemokine levels in patients with HIV-associated eosinophilic folliculitis

Background  Patients with human immunodeficiency virus (HIV) infection exhibit various skin diseases. HIV-associated eosinophilic folliculitis (EF) and pruritic papular eruption (PPE) are frequently seen. Objective  To understand the mechanisms underlying HIV-associated EF and PPE. Methods  In order to know frequencies of EF and PPE among patients with HIV infection, we first collected HIV+ patients who visited dermatology clinic in National Center for Global Health and Medicine during February 2007. We next collected 25 serum samples from HIV+ patients with skin diseases from May 2008 to May 2010. Eight of 25 patients had EF (EF group), four had PPE (PPE group) and others had non-itchy skin problems such as condyloma acuminatum (no itch group). Results  We first confirmed high frequencies of EF (10.7%) and PPE (5.3%) among 75 HIV+ patients who visited our clinic during one month. We then measured serum levels of CCL11, CCL17, CCL26 and CCL27. Serum CCL17 levels in EF were significantly higher than those of PPE and no itch group. Serum CCL26 and CCL27 levels in EF were higher than those of no itch group. The number of CD4+ cells in EF was significantly lower than that in no itch group. Conclusion  High serum levels of CCL17, CCL26 and CCL27, and low CD4+ cell counts may account for the development of HIV-associated EF.