Department of Pathology, Sree Siddhartha Medical College, Hospital and Research Centre, Tumkur, Karnataka, India.
Indian J Dermatol Venereol Leprol. 2010 May-Jun;76(3):259-62. doi: 10.4103/0378-6323.62965.
Itchy folliculitis are pruritic, folliculo-papular lesions seen in human immunodeficiency virus (HIV)-infected patients. Previous studies have shown that it was impossible to clinically differentiate between eosinophilic folliculitis (EF) and infective folliculitis (IF). Also, attempts to suppress the intense itch of EF were ineffective.
The present study is aimed at correlating clinical, histopathological and immunological features of itchy folliculitis in HIV patients along with their treatment.
The present prospective study lasted for 36 months (September, 2005 to August, 2008) after informed consent, data on skin disorders, HIV status and CD4 count were obtained by physical examination, histopathological examination and laboratory methods.
Of 51 HIV-positive patients with itchy folliculitis, the predominant lesion was EF in 23 (45.1%) followed by bacterial folliculitis in 21 (41.2%), Pityrosporum folliculitis in five (9.8%) and Demodex folliculitis in two (3.9%) patients. The diagnosis was based on characteristic histopathological features and was also associated with microbiology confirmation wherever required. EF was associated with a lower mean CD4 count (180.58 +/- 48.07 cells/mm3, P-value < 0.05), higher mean CD8 count (1675.42 +/- 407.62 cells/mm3) and CD8/CD4 ratio of 9.27:1. There was significant reduction in lesions following specific treatment for the specific lesion identified.
Clinically, it is impossible to differentiate itchy folliculitis and therefore it requires histopathological confirmation. Appropriate antimicrobial treatment for IF can be rapidly beneficial. The highly active antiretroviral therapy along with Isotretinoin therapy has shown marked reduction in the lesions of EF. Familiarity with these lesions may help in improving the quality of lives of the patients.
瘙痒性毛囊炎是一种发生在人类免疫缺陷病毒（HIV）感染者中的瘙痒性、毛囊性丘疹性损害。既往研究表明，临床上无法区分嗜酸性毛囊炎（EF）和感染性毛囊炎（IF）。此外，尝试抑制 EF 的剧烈瘙痒也无效。
本研究旨在分析 HIV 患者瘙痒性毛囊炎的临床、组织病理学和免疫学特征及其治疗方法。
本前瞻性研究于 2005 年 9 月至 2008 年 8 月进行，共 36 个月，患者知情同意后，通过体格检查、组织病理学检查和实验室方法获得皮肤疾病、HIV 状态和 CD4 计数的数据。
在 51 例 HIV 阳性伴瘙痒性毛囊炎患者中，主要病变为 EF23 例（45.1%），其次为细菌性毛囊炎 21 例（41.2%）、糠秕孢子菌性毛囊炎 5 例（9.8%）和蠕形螨性毛囊炎 2 例（3.9%）。诊断基于特征性组织病理学特征，并在需要时结合微生物学确认。EF 与较低的平均 CD4 计数（180.58±48.07 个/mm3，P 值<0.05）、较高的平均 CD8 计数（1675.42±407.62 个/mm3）和 CD8/CD4 比值（9.27:1）相关。根据确定的特定病变进行特定治疗后，皮损显著减少。
临床上无法区分瘙痒性毛囊炎，因此需要组织病理学确认。针对 IF 的适当抗菌治疗可迅速获益。高效抗逆转录病毒治疗联合异维 A 酸治疗显示 EF 皮损明显减少。熟悉这些病变有助于提高患者的生活质量。
