Progressive supravenous granulomatous nodular eruption in a human immunodeficiency virus-positive intravenous drug user treated with highly active antiretroviral therapy

Br J Dermatol. 2008 Jan;158(1):145-9. doi: 10.1111/j.1365-2133.2007.08238.x. Epub 2007 Oct 17.

Abstract

We describe a 41-year-old human immunodeficiency virus-infected woman with a previous history of intravenous drug abuse, who developed multiple linear nodules following the superficial veins on both arms. Histopathological examination disclosed a dermal histiocytic inflammatory reaction with sarcoid-like granuloma formation occasionally showing an intracytoplasmic refractile material in the histiocytic cells. Nodular lesions developed progressively after starting on highly active antiretroviral therapy (HAART) which increased her CD4 cell count and suppressed her viral load. The appearance of latent inflammatory or autoimmune disease following HAART is a well-recognized phenomenon. We consider that this peculiar 'progressive supravenous granulomatous nodular eruption' should be included within the spectrum of the so-called immune reconstitution inflammatory syndrome.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active / adverse effects
  • Disease Progression
  • Female
  • Granuloma, Foreign-Body / etiology
  • Granuloma, Foreign-Body / pathology*
  • HIV Infections / drug therapy*
  • Humans
  • Immune Reconstitution Inflammatory Syndrome / diagnosis
  • Immune Reconstitution Inflammatory Syndrome / etiology
  • Immune Reconstitution Inflammatory Syndrome / pathology*
  • Skin Diseases / etiology
  • Skin Diseases / pathology*
  • Substance Abuse, Intravenous / complications*