| • | HIV-associated; pathogenesis unknown |
| • | lesions have the appearance of small insect bites (papular urticaria), and much less commonly pustules |
| • | head, neck, upper back and arms |
| • | chronic course that waxes and wanes |
| • | usually low CD4 count (<200) |
| • | but with HAART, EF can recur or flare in association with increasing CD4 count and decreasing viral loads (i.e. patients get it on the way down, but also on the way back up as their CD4 count improves and the immune system is again able to mount a reaction - this tends to occur at the same CD4 counts as it did on the way down, but then resolves as the CD4 counts improve to a sufficient number) |
treatment options:
| • | IM injection (to treat EPF or pruritis): triamcinolone 40mg/cc X 1cc (slow acting) and celestone 6mg/cc X 1cc (fast acting) |
| • | accutane 10 – 20 – 40 mg/day (almost 100% effective) |
| • | Indomethacin 50 to 75mg daily |
| • | Itraconazole 100 to 400mg/day |
|