光敏性皮炎50例分析

对５０例光敏性皮炎进行了分析，其中仅６例发病原因明确，余均无明确的光敏物质接触史，在无明确病因的病人中，有２５例呈季节性发病；１９例发病无季节性，但其中７例在早期呈季节性发病，后渐转变无季节性，有４４例进行了光敏试验，全部病例对ＵＶＡ的敏感性均明显增加约半数患者对ＵＶＢ的敏感性也增高。     

HIV感染的皮肤表现

ＨＩＶ感染的皮肤表现孙仁山刁庆春（重庆市第三军医大学西南医院皮肤科６３００３８）人类免疫缺陷病毒（ＨｕｍａｎｌｍｍｕｎｏｄｅｆｉｃｉｅｎｃｙＶｉｒｕｓ，ＨＩＶ）感染与皮肤病有密不可分的联系，主要表现在：（１）大多数ＨＩＶ疾病均有皮肤上的表现，资料显示...     

趋化因子与HIV感染

趋化因子在人类免疫缺陷病毒感染中的作用日益受到重视,CD8~+T细胞所分泌的趋化因子,如活化后可调节的、正常T细胞表达并可能分泌的因子、巨噬细胞炎性蛋白-1α及巨噬细胞炎性蛋白-1β可抑制人类免疫缺陷病毒的复制,趋化因子受体CXCR4和CCR5则可作为人类免疫缺陷病毒的共同受体,CCR5基因缺失与某些反复接触人类免疫缺陷病毒而未发生感染的个体对人类免疫缺陷病毒感染的抵抗性有关,这些证据有助于更好地阐明人类免疫缺陷病毒感染的发病机理并有望开创治疗和预防人类免疫缺陷病毒感染的新途径。     

趋化因子与HIV感染

趋化因子在人类免疫缺陷病毒感染中作用日益受到重视，ＣＤ８＾＋Ｔ细胞所分泌的趋化因子，如活化后可调节的、正常Ｔ细胞表达并可能分泌的因子、巨噬细胞炎性蛋白－１α及巨噬细胞炎性蛋白－１β可抑制人类缺陷病毒的复制，趋化因子受体ＣＸＣＲ４和ＣＣＲ５则可作为人类免疫缺陷病毒的共同受体，ＣＣＲ５基因缺失与其某些反复接触人类免疫缺陷病毒而未发生感染的个体对人类免疫缺陷病毒感染的抵抗性有关，这些语气有助于更好地阐明     

HIV感染者并发双侧带状疱疹1例

患者男,23岁。左侧腰背部、右侧胸背部红斑、水疱伴疼痛3d。患者为男男同性恋者,2个月前确诊为HIV感染者。查体见左侧腰背部、右侧胸背部片状红斑基础上见米粒至绿豆大小簇集性水疱、丘疱疹、血疱,疱液清,疱壁紧张,部分破溃结痂。皮疹呈带状沿神经走行分布。血WBC3.2×109/L,其他辅助检查均未见异常。诊断：双侧带状疱疹并HIV感染。     

婚检发现HIV感染1例

江苏常州婚检人群检出首例HIV感染者。患者男,28岁,常州籍,工人。婚前常规体检:T36.4℃,无皮疹、淋巴结肿大、口腔溃疡;无皮肤瘙痒;无腹痛、腹胀、腹泻等不适;B超示肝、脾、肾未见异常;血常规、尿常规正常,丙氨酸氨基转移酶(ALT)正常、乙肝表面抗原(HBsAg)阴性,梅毒螺旋体抗体阴性,血液筛查和确证为HIV-1抗体阳性。流行病学调查为经性途径传播所致的无症状HIV感染者。建议在婚检中引入艾滋病筛查。     

孕产妇HIV感染及其监测情况

近年来，全世界女性艾滋病毒感染率呈上升趋势，艾滋病在孕妇中的流行将贻祸后代。从世界范围来看，孕产妇感染HIV非常普遍，不同时间、不同国家或同一国家不同地区，HIV的流行是极不平衡的，增长或下降的趋势也是不同的。在非洲以及亚洲的泰国、柬埔寨孕产妇感染HIV以经性途径传播为主。而在我国，传播途径为输血和性两种传播性途径。产前HIV筛查和咨询对预防和控制HIV的垂直传播有着十分重要的意义，在我国应加强孕产妇HIV的哨点监测工作。     

男男性行为者HIV感染并发多种性病1例

患者男,28岁,未婚.因肛周赘生物伴肛周溃疡和疼痛1个月余于2008年6月8日.2年前,因肛周赘生物在外地就医,诊断为肛周尖锐湿疣(CA),经激光去疣及抗病毒药物治疗(用药不详),皮损消退.此后多次复发,复发间隔时间1～3个月,期间在多家医院就诊,均按"肛周CA"治疗.     

An open-label efficacy pilot study with pimecrolimus cream 1% in adults with facial seborrhoeic dermatitis infected with HIV

BACKGROUND: Seborrhoeic dermatitis (SD) is a common dermatosis in human immunodeficiency virus (HIV)-positive patients, many of whom do not respond satisfactorily to conventional topical treatments such as corticosteroids and antifungals. OBJECTIVE: A pilot study to investigate the efficacy and tolerability of pimecrolimus cream 1% in HIV-positive patients with facial SD. METHODS: In a single-centre study, 21 HIV-infected patients with mild to severe SD were treated twice daily with pimecrolimus cream 1% for 14 days. Thereafter, treatment was discontinued and patients followed up for 5 weeks. Skin involvement at baseline and on days 7, 14, 21, 35 and 49 was assessed using a four-point clinical score and digital photography. MAIN OUTCOME MEASURES: Efficacy and safety of pimecrolimus cream 1% treatment and incidence of relapse in the follow-up phase. Results Marked improvement was seen in clinical parameters at day 7, with >or= 90% patients clear of symptoms at day 14. Relapse was observed at day 35 but signs were milder than at baseline. All patients responded to therapy, despite their immunological status. Pimecrolimus did not alter CD4(+) and CD8(+) T-cell counts or viral load during the treatment period. CONCLUSION: Pimecrolimus cream represents a new, effective therapeutic option for facial SD in HIV patients.     

Relation of allergy to HIV infection

In this retrospective study on 141 HIV-positive subjects, allergy was studied by a specific questionnaire and the Phadia-Top-Test, an in vitro screening test detecting specific IgE; both were correlated to the patient's history, clinical symptoms and the treatment used. Allergy was studied in reference to HIV-negative controls and in relation to the clinical and biological subgroups of HIV patients.
The application of the x² test demonstrated a high incidence of allergy and a specific relation to the HIV infection compared to the controls as well as in relation to the clinical stage of the infection. Atopy was not specifically related to the HIV infection despite the higher frequency found in the AIDS-IKEL group.
A significant number (21%) of patients with T4 > 300/μ1 considered immunocompetent presented clinical manifestations of AIDS-IKEL and 100% of these patients were allergic. A significant number (19%) of patients with T4 < 300/μ1 considered immunodeficient were asymptomatic and 75% of them were allergic.
Thus allergic symptoms may transiently be the only clinical manifestations in HIV infection and possibly a co-factor for the evolution of the disease due to the immunomodulatory function of the mediators, the cytokines and the proteases released during allergic reaction.     

Photosensitive dermatitis due to sunscreen allergy in a child

We report a case of photoallergic contact dermatitis to two sunscreen agents, methoxycinnamate and oxybenzone, occurring in a 6-year-old Asian boy.     

Malassezia spp carriage in patients with seborrheic dermatitis.

The role of Malassezia spp in seborrheic dermatitis (SD) is controversial. To compare the cutaneous density and the cultural characteristics of Malassezia in persons with or without SD, quantitative cultures were obtained by stripping the forehead with a tape placed on Leeming and Notman medium. Plates were incubated at 37 degrees C in a plastic bag, and colonies were counted after 14 days. High yeast density was defined as > 100 colony forming units (CFU)/tape. Volunteers were divided into four groups depending on their HIV serology [HIV (+) versus HIV (-) or unknown] and their clinical status (with or without SD). 126/129 cultures were positive (97.7%). Malassezia spp density was low on clinically normal skin in all HIV (-) persons (40/40) but was high in 8/34 (24%) HIV (+) persons without SD (p < 0.001). In SD patients, high densities were found in 10/22 (45%) HIV (+) and in 17/33 (52%) HIV (-) persons. The strains could be divided into three basic groups on the basis of their cultural characteristics. Colony morphology type A predominated on normal skin (72%), and morphology type C predominated on persons with SD (78%). High yeast density can be present without skin symptoms. The pathogenicity of Malassezia seems more likely to be determined by the subtype present on the skin rather than by its density.     

Similar appearance,different mechanisms: xerosis in HIV,atopic dermatitis and ageing

Xerosis is one of the most common dermatologic disorders occurring in the elderly and in patients with atopic dermatitis (AD) and human immunodeficiency virus (HIV) infection. Xerosis has been linked to an impaired skin barrier function of the stratum corneum. Using Raman microspectroscopy, we concentrated on deeper skin layers, viable epidermis and dermis of 47 volunteers and associated molecular alterations to the evolution of xerosis and the skin barrier, for example, lipid, water and antioxidant content. A decrease in lipids within the viable epidermis is found for elderly and HIV‐patients. Lipid and water values of AD patients and their healthy reference group are similar. Decreases in lipids and simultaneous increases in water are found in the dermis for HIV and AD patients in comparison to their healthy reference groups. Excessive levels of epidermal carotenoids, mainly lycopene, in HIV‐patients were found potentially leading to adverse effects such as premature skin ageing.     

Erythema multiforme associated with contact dermatitis

A garment worker developed erythema multiforme concurrently with allergic contact dermatitis of the hands. Patch testing revealed sensitivity to nickel (which was present in her scissors) and to paraphenylenediamine (a commercial dye). During the course of the patch-test evaluation, both the hand dermatitis and the erythema multiforme became exacerbated. Later, patch testing to only nickel sulfate resulted in the development of erythema multiforme on the face and hands. The allergic pathogenesis, involving the absorption of an allergen through the skin and resulting in a type III allergic reaction from nickel, is discussed.     

Sites of dermatitis in a patch test population: hand dermatitis is associated with polysensitization

Background  Sites of dermatitis in larger series of contact allergic patients are rarely reported. Increased risk of polysensitization has been linked only to stasis dermatitis and leg ulcers. However, a large proportion of polysensitized individuals may have dermatitis in other skin areas.
Objectives  To examine the site of dermatitis at time of first appearance in contact allergic individuals with special focus on the distribution of dermatitis in polysensitized individuals and to examine if widespread dermatitis is more frequent in polysensitized than in single/double-sensitized patients.
Methods  A matched case–control study was carried out including 394 polysensitized and 726 single/double-sensitized patients who responded to a postal questionnaire. All subjects were recruited from a hospital patch test population.
Results  The hands were the most frequent and the anogenital region was the least frequent skin area affected with dermatitis. Dermatitis on the hands/wrists [odds ratio (OR) 1·58], in the armpits (OR 1·56) and on the back (OR 1·91) was positively associated with polysensitization. The hands were the only skin area with dermatitis which maintained the association to polysensitization in two subpopulations consisting of, respectively, individuals with and without atopic eczema. Dermatitis on the scalp was negatively associated with polysensitization (OR 0·66) primarily for individuals without atopic eczema. The dermatitis did not seem to be more widespread in polysensitized compared with single/double-sensitized patients.
Conclusions  Special awareness in patients with hand dermatitis seems justified either to prevent development of multiple contact allergies or to document polysensitization as an aetiological factor.     

天津市中老年HIV阳性病例婚内传播及死亡影响因素

目的:了解中老年HIV阳性病例配偶感染情况及死亡影响因素。方法:统计全国艾滋病防治信息系统中天津市报告的45岁以上HIV阳性病例的配偶感染情况和死亡比例,并对其影响因素进行相关分析。结果:截止2015年8月底共筛选427例中老年HIV阳性病例,配偶感染率为25.95%;死亡比例为22.48%,高年龄和未治疗是影响死亡的主要因素。结论:中老年HIV阳性病例死亡率和婚内感染率高,应该加强中老年人群HIV主动检测工作,早发现,早治疗。