Approach to pruritus in the adult HIV-positive patient.

Pruritus will affect a majority of HIV-infected adults in the course of their disease, impacting their quality of life. Itchy skin conditions in the HIV-infected patient may be atypical in appearance and pose diagnostic and treatment challenges. Skin changes because of chronic scratching or the absence of skin findings despite ongoing pruritus should prompt investigations for underlying causes. The presence of pruritus or pruritic skin conditions and their response to therapy may be a barometer for changes in systemic inflammation, immune activation, and dysregulation because of infection with HIV and treatment with antiretroviral therapy.