Le prurigo en milieu tropical : importance de son association avec l'infection à VIH

A retrospective study was conducted of 1002 patients diagnosed with a dermatological condition in French Guiana during 1982-1991. 216 patients tested positive for HIV infection. 30% of all HIV-infected dermatology patients had prurigo. In 19% of these cases it was the revealing clinical element of HIV infection. 70% of the HIV-infected dermatology patients had AIDS. HIV-infected patients with prurigo were Haitians (40%) Creoles living in French Guiana (17%) and French (11%). Prurigo as a marker of HIV infection had poor sensitivity (50%) and poor positive predictive value (36%) but acceptable specificity (92%) and acceptable negative predictive value (85%). The prevalence of prurigo was greatest among HIV-positive persons with the lowest CD4 counts (45% for CD4 200). Immunoglobulin E was higher in prurigo patients with HIV/AIDS than in those with no HIV infection (3648 vs. 531 UI/ml). Like infantile prurigo HIV-associated prurigo is a reaction to an arthropod bite that is exacerbated in a tropical environment.