Pruritic Skin Eruption in the Acquired Immunodeficiency Syndrome: Arthropod Bites?

To the Editor.—  Liataud and colleagues¹ must be commended on their well-researched article highlighting pruritic skin lesions as a common initial presentation of the acquired immunodeficiency syndrome. The authors have considered, and excluded, the possibility of insects being causative on the basis of histopathologic data as well as a similar density of lesions in exposed and unexposed parts of the body.However, the clinical photograph showing the morphology of an acute lesion (Fig 1 in the article) is, in my opinion, characteristic of an insect bite. Though the authors state that ".. a similar density of lesions in exposed and unexposed parts of the body in some patients are not suggestive of insect bites," Fig 2 shows a clear predominance of lesions on the extremities (exposed areas). It is important to take into consideration the type of clothing worn—in hot and humid climates it is not uncommon for the local populace