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NEJM：红皮病型银屑病和HIV感染-病例报道

2019-01-03 xing.T MedSci原创

红皮病型银屑病HIV感染红斑
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广泛性红斑和斑块形成的鉴别诊断包括红皮病性银屑病、脂溢性皮炎和毛发糠疹。从背部两个区域获得的穿孔活检标本证实了红皮病型银屑病的诊断。红皮性丘疹鳞状喷发可能与潜在的全身性疾病有关。

患者为一名29岁的男子，因2年前首次出现的瘙痒、红斑和鳞状皮疹而到皮肤科门诊就诊。在此次就诊之前，他一直没有寻求任何治疗。他的病史包括儿童时期的湿疹和季节性过敏，没有服用过任何药物。

体格检查显示红斑、紫癜性斑块（如图A所示），涉及患者体表面积的90％以上，部分区域（例如背部）保留并反映患者皮肤的基础外观（图B中箭头所示）。



广泛性红斑和斑块形成的鉴别诊断包括红皮病性银屑病、脂溢性皮炎和毛发糠疹。从背部两个区域获得的穿孔活检标本证实了红皮病型银屑病的诊断。红皮性丘疹鳞状喷发可能与潜在的全身性疾病有关。

该患者人类免疫缺陷病毒（HIV）感染的检测结果为阳性。患者接受高效抗逆转录病毒疗法以及局部曲安奈德治疗。在3个月后的随访中，患者皮疹完全清除，并伴有一些残留的色素沉着。

原始出处：

Alexandra A. Bowles,et al.Erythrodermic Psoriasis and HIV Infection.N Engl J Med 2018;https://www.nejm.org/doi/full/10.1056/NEJMicm1810005

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  1. [GetPortalCommentsPageByObjectIdResponse(id=2003900, encodeId=10962003900ed, content=<a href='/topic/show?id=0a04e714467' target=_blank style='color:#2F92EE;'>#红皮病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77144, encryptionId=0a04e714467, topicName=红皮病)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=47c5349, createdName=tastas, createdTime=Fri Nov 01 22:36:00 CST 2019, time=2019-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358341, encodeId=f3b7358341b5, content=很好的资料，谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2019/01/16/f56f817d9c91d8402bb038d8a3c4405d.jpg, createdBy=1fc42532298, createdName=龙湖胤龙湖玮骗钱, createdTime=Wed Jan 16 15:13:05 CST 2019, time=2019-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=357059, encodeId=b1c135e059bc, content=谢谢分享，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Thu Jan 03 09:46:27 CST 2019, time=2019-01-03, status=1, ipAttribution=)]
    2019-11-01 tastas

    #红皮病#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2003900, encodeId=10962003900ed, content=<a href='/topic/show?id=0a04e714467' target=_blank style='color:#2F92EE;'>#红皮病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77144, encryptionId=0a04e714467, topicName=红皮病)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=47c5349, createdName=tastas, createdTime=Fri Nov 01 22:36:00 CST 2019, time=2019-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358341, encodeId=f3b7358341b5, content=很好的资料，谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2019/01/16/f56f817d9c91d8402bb038d8a3c4405d.jpg, createdBy=1fc42532298, createdName=龙湖胤龙湖玮骗钱, createdTime=Wed Jan 16 15:13:05 CST 2019, time=2019-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=357059, encodeId=b1c135e059bc, content=谢谢分享，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Thu Jan 03 09:46:27 CST 2019, time=2019-01-03, status=1, ipAttribution=)]
    2019-01-16 龙湖胤龙湖玮骗钱

    很好的资料，谢谢分享

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2003900, encodeId=10962003900ed, content=<a href='/topic/show?id=0a04e714467' target=_blank style='color:#2F92EE;'>#红皮病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77144, encryptionId=0a04e714467, topicName=红皮病)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=47c5349, createdName=tastas, createdTime=Fri Nov 01 22:36:00 CST 2019, time=2019-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358341, encodeId=f3b7358341b5, content=很好的资料，谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2019/01/16/f56f817d9c91d8402bb038d8a3c4405d.jpg, createdBy=1fc42532298, createdName=龙湖胤龙湖玮骗钱, createdTime=Wed Jan 16 15:13:05 CST 2019, time=2019-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=357059, encodeId=b1c135e059bc, content=谢谢分享，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Thu Jan 03 09:46:27 CST 2019, time=2019-01-03, status=1, ipAttribution=)]
    2019-01-03 明月清辉

    谢谢分享，学习了

    0