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Pustular eruption on the face revealing HIV infection
Imane Couissi
, Hanane Baybay, Meryem Soughi, Zakia Douhi, Sara El Loudi, Fatima Zahra Mernissi
Department of Dermatology, University Hospital Hassan II Fès, Morocco
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© Our Dermatology Online 2024. No commercial re-use. See rights and permissions. Published by Our Dermatology Online.
Numerous infections arise during the course of an HIV-positive person’s evolution, most often leading to AIDS disease. Most of them are said to be opportunistic and induced by severe immunodepression.
HIV-associated suppurative folliculitis is usually of bacterial origin [1]. When bacterial cultures are performed, Staphylococcus aureus is the most often organism implicated [2].
Bacterial folliculitis is common in HIV patients, whose immunity is still apparently normal but in fact, recognizes a qualitative deficit. However, they occur in almost one out of two AIDS patients in an advanced immunodepressive situation.
In a study of 40 HIV-positive patients, suppurative folliculitis was the cause of follicular eruptions in two-thirds of cases [3].
We report a case of suppurative folliculitis limited to the face revealing an HIV infection.
A 45-year-old divorced man who has just been released from prison, presented with a week’s history of pustular eruption on the face and a flu-like syndrome (fever, chills, and sore throat) one week prior. Clinical examination showed multiple confluent follicular and non-follicular pustules on the face, forehead, and lateral aspect of the neck on erythematous skin (Figs. 1a – 1d). Examination of the oral mucosa found pharyngitis.
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Figures 1: (a-d) Clinical picture showing multiple confluent follicular and non-follicular pustules on the face, forehead, and lateral aspect of the neck. |
HIV infection was suspected given the patient’s history, symptoms and was confirmed by serology. The patient was put on macrolide and a skin biopsy was planned but the pustular lesions have disappeared (Figs. 2a – 2d).
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Figures 2: (a-d) Clinical picture showing the disappearance of the lesions after antibiotic treatment. |
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The examination of the patient was conducted according to the principles of the Declaration of Helsinki.
REFERENCES
1. Gelfand JM, Rudikoff D. Evaluation and treatment of itching in HIV-infected patients. Mt Sinai J Med.2001;68:298–308.
2. Ekpe O, Forae GD, Okpala CI. Pruritic papular eruption of HIV:a review article. Our Dermatol Online. 2019;10:191-6.
3. Guzman AK, Pappas-Taffer LK, Elston DM, James WD. Acute and recurrent facial pustulosis:a unique clinical entity?J Eur Acad Dermatol Venereol. 2018 May;32:e193-e195.
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