HIV: pruritic papular eruption: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · HIV: pruritic papular eruption

Sample item

A man with advanced HIV (CD4 count 90 per microlitre) has intensely itchy, symmetrical, discrete skin-coloured and excoriated papules on the extremities and trunk, with negative scabies tests. What is the best management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Start antiretroviral therapy with antihistamines and topical steroids

Pruritic papular eruption of HIV is a common, intensely itchy condition in patients with low CD4 counts, and its cause is unclear but may relate to insect bite hypersensitivity. Immune restoration with ART is the key treatment, with antihistamines and topical steroids for symptoms. Other causes such as scabies should be excluded.

Option by option

  • A. Treat as scabies with repeated permethrin

    Scabies is excluded by the negative tests.

  • B. Start oral isotretinoin

    Isotretinoin has no role.

  • C. Start antiretroviral therapy with antihistamines and topical steroids (correct)

    Correct. ART plus symptomatic therapy is the core approach.

  • D. Give intravenous acyclovir

    Acyclovir does not treat this eruption.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is C, Start antiretroviral therapy with antihistamines and topical steroids. Pruritic papular eruption of HIV is a common, intensely itchy condition in patients with low CD4 counts, and its cause is unclear but may relate to insect bite hypersensitivity.

Why is "Treat as scabies with repeated permethrin" not the answer?

Scabies is excluded by the negative tests.

Why is "Start oral isotretinoin" not the answer?

Isotretinoin has no role.

Why is "Give intravenous acyclovir" not the answer?

Acyclovir does not treat this eruption.

What concept does this question test?

It tests HIV: pruritic papular eruption in Dermatology. Immune restoration with ART is the key treatment, with antihistamines and topical steroids for symptoms. Other causes such as scabies should be excluded.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study HIV: pruritic papular eruption?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.