Tzung Tien-Yi, Yang Chia-Yi, Chao Sheau-Chiou, Lee J Yu-Yun
Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2004 May;20(5):216-24. doi: 10.1016/S1607-551X(09)70109-3.
Cutaneous manifestations are common and often the presenting feature of human immunodeficiency virus (HIV) infection, but a comprehensive study of HIV-associated skin lesions is not available in Taiwan. We reviewed all skin lesions in all HIV patients diagnosed in our department between 1990 and 1998 to document the spectrum of skin manifestations, the frequency of each disorder, and their relationship with CD4 counts. A total of 64 HIV patients were studied, including 38 with acquired immunodeficiency syndrome (AIDS) (CD4 < 200 x 10(6) cells/L) and 26 who had not developed AIDS (non-AIDS). There were 142 episodes of skin conditions representing 25 different skin diseases, including oral candidiasis (15% in non-AIDS vs 71% in AIDS patients), drug eruptions, herpes simplex, seborrheic dermatitis, dermatophytosis, herpes zoster, secondary syphilis, condyloma acuminatum, Kaposi's sarcoma (16% among AIDS patients), hairy leukoplakia, and molluscum contagiosum (13% among AIDS patients), in decreasing order. Several unusual cases are briefly described, including verrucous herpes infection, condyloma-like molluscum contagiosum, and AIDS-associated pigmented erythroderma. In our study, 70% of all HIV patients had skin diseases, with an average of 2.2 conditions per patient (3.2 in AIDS patients vs 0.7 in non-AIDS patients; p < 0.001). A broad spectrum of HIV-associated skin diseases was observed in our series. The frequency of HIV-associated skin disease was 92% in AIDS patients and 39% in non-AIDS patients; 78% of skin lesions in AIDS patients were diagnosed when CD4 counts were below 100 x 10(6) cells/L.
皮肤表现很常见，且常常是人类免疫缺陷病毒（HIV）感染的首发特征，但台湾地区尚无关于HIV相关皮肤病变的全面研究。我们回顾了1990年至1998年间在我院确诊的所有HIV患者的皮肤病变情况，以记录皮肤表现的范围、每种疾病的发生率及其与CD4细胞计数的关系。共研究了64例HIV患者，其中38例患有获得性免疫缺陷综合征（AIDS）（CD4＜200×10⁶个细胞/L），26例尚未发展为AIDS（非AIDS患者）。共出现142次皮肤病变，代表25种不同的皮肤疾病，按发生率递减顺序依次为口腔念珠菌病（非AIDS患者中占15%，AIDS患者中占71%）、药疹、单纯疱疹、脂溢性皮炎、皮肤癣菌病、带状疱疹、二期梅毒、尖锐湿疣、卡波西肉瘤（AIDS患者中占16%）、毛状白斑和传染性软疣（AIDS患者中占13%）。文中简要描述了几例罕见病例，包括疣状疱疹感染、疣状传染性软疣和AIDS相关色素性红皮病。在我们的研究中，70%的HIV患者患有皮肤病，每位患者平均有2.2种疾病（AIDS患者为3.2种，非AIDS患者为0.7种；p＜0.001）。我们的系列研究中观察到了广泛的HIV相关皮肤病。AIDS患者中HIV相关皮肤病的发生率为92%，非AIDS患者为39%；78%的AIDS患者皮肤病变是在CD4细胞计数低于100×10⁶个细胞/L时被诊断出来的。
