My question is...is it possible to have the ARS rash only on the underneath of one arm and not on the chest, back, or face...and if it actually is the ARS rash, would there more than likely be a fever?
I have had unprotected sex one time recently, and at about 2 weeks later I now have a rash of small, red, clustered bumps from my arm pit on the right side down to my wrist and only on the under side of the arm. It actually resembles a poison ivy rash, but I know it is not poison ivy and it only itches a little bit. It is like a million little tiny bumps all down my arm. I just don't know if it is possible just to have the rash on one arm and no where else.
Answer provided by:
Rodger MacArthur, M.D.
Wayne State University
Division of Infectious Diseases
The acute retroviral syndrome is the body's response to infection with HIV. As such, it is a multi-system process, with multiple manifestations. The signs and symptoms of the acute retroviral syndrome typically appear 1-6 weeks following an exposure to HIV, averaging 2-3 weeks after exposure. Signs and symptoms persist for an average of 10-20 days.
To make the diagnosis of the acute retroviral syndrome, three components are needed: 1) a compatible clinical syndrome; 2) detectable (usually very high) levels of HIV RNA (or p24 antigen); and 3) a negative or indeterminate ELISA and Western Blot antibody test for HIV. The ELISA and Western Blot tests are negative or indeterminate because it takes several weeks after the signs and symptoms appear for the body to produce detectable levels of antibody to HIV.
The signs and symptoms of the acute retroviral syndrome are non-specific. There is no minimum number of signs and symptoms necessary for diagnosis, but fever (usually high) typically is present in over 90% of the cases, and multiple other signs and symptoms typically are present. These signs and symptoms include, but are not limited to: a non-specific, generalized rash; lymphadenopathy; pharyngitis; gastrointestinal complaints; hepatosplenomegaly; arthralgias and myalgias; headache. The rash, when present, is diffuse and not unilateral (one-sided).
The symptoms described in this question seem to be limited to a unilateral rash. Therefore, it seems extremely unlikely that this rash is a manifestation of the acute retroviral syndrome. It is difficult to determine from the description given the exact cause of the rash. If vesicles (blisters) are present, shingles (herpes zoster) needs to be considered, which can be seen in persons with ongoing HIV infection (but not typically as a manifestation of the acute retroviral syndrome). Other possibilities include contact dermatitis (allergic reaction); cellulitis (infection of the skin, caused by bacteria such as staphylococcus and streptococcus); folliculitis (infection of the hair follicles); Taenia corporis (mild fungal infection of the body); herpes simplex; heat rash.
If there is continued concern about exposure to HIV in this instance, voluntary HIV testing should be pursued, as sufficient time has passed from exposure to make it likely that an antibody test would be positive if HIV infection actually did occur.