艾滋病合并红皮病型银屑病、脓疱疮及梅毒1例
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摘要
患者男,23岁。全身红斑、斑块、鳞屑伴瘙痒5个月,头面部脓疱、糜烂1个月。患者既往确诊为艾滋病、梅毒。实验室检查:HIV抗体初筛及确认试验阳性,CD4~+T细胞39 cells/μL,TPPA阳性,TRUST 1∶128;皮损组织病理示:表皮角化过度伴角化不全,可见Munro′s微脓疡,棘层肥厚,真皮毛细血管扩张,血管周围见淋巴细胞、组织细胞浸润。诊断:艾滋病;红皮病型银屑病;脓疱疮;梅毒。
A 23-year-old male presented with erythema,plaque and scales on his body with itching for 5 months,and pustules,erosion on his head and face for 1 month.The patient has been diagnosed as HIV/AIDS and syphilis.Laboratory examination showed HIV antibody screening and confirmation test indicate positive,CD4~+T lymphocytes counted as 39 cells/μL,TPPA positive,TRUST 1∶128.Histopathological biopsy showed epidermal hyperkeratosis with parakeratosis,visible Munro′s microabscess and acanthosis,and the capillary of dermis expanded,with lymphocytes and tissue cells infiltration around the blood vessels.Diagnosis:HIV/AIDS;erythroderma psoriaticum;impetigo and syphilis.
A 23-year-old male presented with erythema,plaque and scales on his body with itching for 5 months,and pustules,erosion on his head and face for 1 month.The patient has been diagnosed as HIV/AIDS and syphilis.Laboratory examination showed HIV antibody screening and confirmation test indicate positive,CD4~+T lymphocytes counted as 39 cells/μL,TPPA positive,TRUST 1∶128.Histopathological biopsy showed epidermal hyperkeratosis with parakeratosis,visible Munro′s microabscess and acanthosis,and the capillary of dermis expanded,with lymphocytes and tissue cells infiltration around the blood vessels.Diagnosis:HIV/AIDS;erythroderma psoriaticum;impetigo and syphilis.
引文
[1] 王椿森,李家文,黄长征,等.皮肤性病免疫学[M].武汉:湖北科技出版社,1999:338-342.
[2] Valenzuela F,Fernández J,Sánchez M,et al.Erythrodermic psoriasis and human immunodeficiency virus:associationand therapeutic challenges[J].An Bras Dermatol,2018,93(3):438-440.
[3] Menon K,Van Voorhees AS,Jr BB,et al.Psoriasis in patients with HIV infection:from the medical board of the National Psoriasis Foundation[J].J Am Acad Dermatol,2010,62(2):291-299.
[4] 赵辨.中国临床皮肤病学[M].南京:江苏科学技术出版社,2010:441-442.
[5] 杨时瀚,李玉叶.HIV/AIDS相关皮肤黏膜损害研究进展[J].皮肤病与性病,2013,35(3):141-144.
[6] 李玉叶,邹燕.梅毒合并艾滋病的诊治[J].皮肤病与性病,2013,35(4):206-207.
[2] Valenzuela F,Fernández J,Sánchez M,et al.Erythrodermic psoriasis and human immunodeficiency virus:associationand therapeutic challenges[J].An Bras Dermatol,2018,93(3):438-440.
[3] Menon K,Van Voorhees AS,Jr BB,et al.Psoriasis in patients with HIV infection:from the medical board of the National Psoriasis Foundation[J].J Am Acad Dermatol,2010,62(2):291-299.
[4] 赵辨.中国临床皮肤病学[M].南京:江苏科学技术出版社,2010:441-442.
[5] 杨时瀚,李玉叶.HIV/AIDS相关皮肤黏膜损害研究进展[J].皮肤病与性病,2013,35(3):141-144.
[6] 李玉叶,邹燕.梅毒合并艾滋病的诊治[J].皮肤病与性病,2013,35(4):206-207.