合并HIV感染的银屑病患者12例临床分析  

Clinical Analysis of 12 Cases of Psoriasis with HIV Infection

作　　者：李浩[1] 徐桂娟 王强[1] 王凯波[1] 韩宪伟[1] 孙晓冬[1] 苏芳[1] 孙晓杰[1] 韩莹[1] 李铁男[1] LI Hao;XU Guijuan;WANG Qiang;WANG Kaibo;HAN Xianwei;SUN Xiaodong;SU Fang;SUN Xiaojie;HAN Ying;LI Tienan(Department of Dermatology,the Seventh Hospital of Shenyang,Shenyang 110003,China)

机构地区：[1]沈阳市第七人民医院皮肤科,辽宁沈阳110003

出　　处：《中国皮肤性病学杂志》2021年第3期283-287,共5页The Chinese Journal of Dermatovenereology

摘　　要：目的探讨合并HIV感染的银屑病患者临床特征。方法收集2015年1月-2019年12月本院收治的12例合并HIV感染的银屑病患者的临床资料,进行回顾性分析。结果12例患者中,寻常性银屑病6例,关节病型银屑病1例,脓疱型银屑病1例,红皮病型银屑病4例;男女比例5∶1;银屑病病史平均(7.88±7.86)年,入院时病情加重平均(1.00±0.57)个月。银屑病皮疹累及头面部6例(50.00%)、躯干12例(100%)、四肢9例(75.00%)、掌跖及指(趾)甲6例(50.00%);伴关节疼痛4例(33.33%)。患者头面、躯干、四肢处皮疹表现为典型的银屑病红斑鳞屑疹,与HIV阴性患者未见明显差异。银屑病PASI评分为(16.67±10.70)分。本次研究中接受治疗的9例患者,CD4^(+)T淋巴细胞均低于正常值,CD4/CD8均低于正常范围,CD4^(+)T淋巴细胞计数越低,病情越重。9例患者均予以复方甘草酸苷静滴,配合外用糖皮质激素药膏等治疗,其中6例患者口服阿维A胶囊20~30 mg/d,治疗有效,但皮疹未完全消退,无死亡病例。结论本组合并HIV感染的银屑病患者12例中,男性居多,以寻常性银屑病为主;患者掌跖及指(趾)甲更易受累;CD4^(+)T淋巴细胞计数越少,银屑病皮疹越重;此类患者早期治疗方案与一般银屑病患者相仿,皮疹难以完全消退,但存活率高。Objective To explore the clinical features of psoriasis patients with HIV infection.Methods A total of 12 patients with psoriasis and HIV infected in our hospital from January 2015 to December 2019 were collected,and the results were analyzed.Results Among the 12 patients,6 cases with psoriasis vulgaris,1 case with psoriatic arthritis,1 case with pustular psoriasis,4 cases with erythrodermic psoriasis.The proportion of male to female was 5 to 1.The average course of psoriasis was(7.88±7.86)years;the average disease progression at admission was(1.00±0.57)months.On distribution of lesions,6 cases(50.00%)involving the head,12 cases(100%)involving the trunk,9 cases(75.00%)involving the limbs,6 cases(50.00%)involving the palms and fingernails,4 cases(33.33%)with joints pain.The rashes on the head,trunk and limbs were typical erythema and scale,which was not significantly different from HIV-negative patients.The PASI score for psoriasis was(16.67±10.70).Total 9 patients were treated in this study,CD4^(+)T lymphocytes was lower than normal,and the ratio of CD4 to CD8 was lower than normal.Nine cases were given intravenous compound glycyrrhizin,combined with topical glucocorticoid ointment,and 6 cases were treated with acitretin capsules at dose 20~30 mg/d.The treatment was effective,but the rash could not be completely resolved,there were no deaths.Conclusion In this study,the majority of patients are male,and with psoriasis vulgaris.The palms and fingernails were prone to abnormalities.The lower of the CD4^(+)T lymphocyte count,the worse of the psoriasis.The early treatment for these patients was similar to ordinary psoriasis patients.It was difficult to resolve the rash completely,but the survival rate was high.

关 键 词：银屑病 HIV 合并感染 临床特征 分析 

分 类 号：R758.63[医药卫生—皮肤病学与性病学] R512.91[医药卫生—临床医学]