Suggest Treatment For Rashes On The Chin And Lips

Posted on Fri, 16 Dec 2016

Question: Hi Doc

A month and a week ago I had an exposure to HIV through an insertive vaginal intercourse condom break (We immediately went for tests afterwards and the girl turned out to be positive). I was put on Post Exposure Prophylaxis after 5hrs, and completed the course (Atripla pills).

In the last week of my pill course I developed a rash that is on my chin and above my top lip. The rash is characterized as being completely flat (in fact it just looks like my normal skin but at a notably darker color). I also have one swollen lymph node on the left side of my neck. I'm worried that this is a sign of PEP failure, thus HIV infection. I must add that before my lymph node went up, I had an ear infection on the same side. I have attached an image of my chin rash. I dont know if its an ARS rash or a reaction to the medication I took for PEP.

I kindly require some expert assistance on this.

Answered by Dr. Manish Purohit (40 minutes later)

Brief Answer:
Dear sir dont be worried as I dont feel it as ARS .

Detailed Answer:
dear sir , thanks for posting your query to HCM.
I can understand your concern but dont be worried as, if you have taken PEP under guidence of expert there is less chances of failure .
complaint which you are mentioned here not specific for HIV infection it could be due to some drug allergy or other viral or bacterial infection .HIV is a slow virus and XXXXXXX develop slowly month to year after expouser .
so dont be worried ,do the blood test for HIV antibody after one month, 3 month and 6 month after your expouser .
presently if facility available at your place you can be tested for HIV nucleic acid detection by PCR to alleviate your worry.
hope I have aolved yourquery. thanks . feel free to contact .

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Manish Purohit (12 minutes later)

Hi Doc

Thanks for your swift reply. Did you get a chance to look at the picture that I posted regarding the rash that is on my chin? The reason why i'm so worried is because I never get rashes. And what does a typical HIV ARS rash look and feel like?

Answered by Dr. Manish Purohit (19 minutes later)

Brief Answer:
I have already gone through your image . Dont be worried .

Detailed Answer:
dear sir dont be worried as I have already gone through your image . such kind of rash can be develop because of some allergen or bacterial infection . XXXXXXX is a late complex develop few year after expouser ,it is not so rapid in development . further I want to explain you that HIV virus do not produce any illness directly . It decreses the resistance of body to other infection , there by different infectious agent produces there manifestation like respiratory infection by tubercle bacteria , GIT infection by parasites , skin infection by fungus and bacteria etc are common infecting agent .
so dont be worried .
feel.free to contact . thanks .

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Manish Purohit (1 hour later)

I think we are on two different pages here doc

What I'm worried about is ARS (acute retroviral syndrome). This is the primary stage of infection (two weeks to 3 months after exposure). This is characterised by rash, fever, swollen lymph nodes, flu-like symptoms that show up after two weeks since you've been infected (It doesnt happen after a few years but after a few weeks) etc.

Surely you've heard of this? I'm not worried about XXXXXXX ..I'm worried about ARS.

Answered by Dr. Manish Purohit (1 hour later)

Brief Answer:
Ok you are right I was thinking about XXXXXXX .

Detailed Answer:
exactly I was thinking about hiv/253657?iL=true" >AIDS related complex .
thanks for description .
but no prob as acute illness is manifested as flu like feature and the reason for this illness is immunological responce of body because of presence of foreign antigen in body . As you have had an contact with HIV positive individual there may be a possibility of entry of viral antigen inside your body . but as you have started PEP it will prevent the cellular infection and further viral multiplication .
So in my opinion your clinical complaint may be because of immunological responce of body as you are on PEP.

however after completion of PEP you should go for viral antigen testing or viral nucleic acid testing .and further viral antibody testing as I suggested to u .
I also suggest to contact your nearby ART and ICTC centere where investigation facility is available free of cost .
thanks . feel free to contact .

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Manish Purohit (31 minutes later)

Thanks doctor I will do that.

So there is a possibility that the rash I have, and my one swollen lymph node could because I have been infected by HIV? (and that PEP failed to protect me?).

And how long after I have finished PEP should I go for these tests?

Answered by Dr. Manish Purohit (13 minutes later)

Brief Answer:
It is not PEP failure.

Detailed Answer:
dont be confused between infection and illness .

entrance of virus inside your body is infection but for illness it will further do involvment of system of body and multiplication .
at this stage we cant say PEP failure as it is a standard regimen and prevent illness not the infection . so dont be panic just calm down and hope for best .
viral antigen appear only during acute infection so you can test that any time after completion of PEP and follow up test for antibody are also important .

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Above answer was peer-reviewed by : Dr. Nagamani Ng