Evaluation and treatment of itching in HIV-Infected patients

Itching is a common complaint among patients infected with HIV and may caus e significant morbidity and embarrassment. Although idiopathic HIV-pruritus has been described, it is probably less common than was previously thought . In most patients, a careful history and physical examination will show th at a dermatosis accounts for their pruritus. Dry skin, seborrheic dermatiti s, eczema, psoriasis, pruritic papular eruption, staphylococcal folliculiti s and prurigo nodularis are frequently encountered in these patients. These common dermatoses, drug eruptions, several rarer conditions and systemic c auses of itching should be excluded before diagnosing idiopathic HIV-prurit us. Treatment should be directed to the underlying skin problem and may be supplemented with sedating antihistamines. Phototherapy is a safe and effec tive therapeutic modality for many pruritic dermatoses as well as for idiop athic pruritus.