以结节性痒疹为首发表现的艾滋病3例及文献复习

结节性痒疹是艾滋病患者较为常见的皮肤表现,是多因素导致的疾病,其皮损与非艾滋病患者相似。本文3例均为男性,临床表现为全身散在丘疹、结节、表皮剥脱、结痂伴剧烈瘙痒,淋巴细胞分类计数示CD4、CD4/CD8比值降低。HIV血清抗体初筛实验及确证实验均(+)。皮损组织病理符合结节性痒疹。2例予抗组胺药物和外用糖皮质激素软膏后症状减轻,1例放弃治疗。沙利度胺是治疗艾滋病相关性结节性痒疹最有效的药物。

Prurigo Nodularis as the Initial Cutaneous Manifestation in HIV-infected Individuals:Case Report and Literature Review

Prurigo nodularis is a common cutaneous manifestation of HIV infection. Prurigo nodularis is probably a disease with multiple causes which result in a clinical and histopathologic presentation similar to that of HIV-seronegative individuals. Three male patients with HIV related prurigo nodularis were described in detail and the related literatures were reviewed. The typical skin lesions presented with hyperkeratotic papules,nodules,excoriation and crusting with a history of intense,chronic pruritus. All the patients were found to be HIV positive and associated with decrease in CD4+ counts and the ratios of CD4+:CD8+. Histopathologic study of the biopsy specimen supported the diagnosis of prurigo nodularis. Two of three men,who were treated with systemic antihistamine and topical corticosteroids cream,got a significant relief of pruritus. However,another one gave up therapy. Of the systemic agents that have been used to treat prurigo nodularis,thalidomide has the most well-documented efficacy.