Department of Dermatology, Chelsea and Westminster Hospital, 369 Fulham Road, London, UK.
Lancet Infect Dis. 2010 Jul;10(7):470-8. doi: 10.1016/S1473-3099(10)70101-8.
Psoriasis is a chronic papulosquamous skin disease that is thought to be a T-cell-mediated autoimmune disorder of keratinocyte proliferation. The association between psoriasis and HIV infection seems paradoxical, but insights into the role of T-cell subsets, autoimmunity, genetic susceptibility, and infections associated with immune dysregulation might clarify our understanding of the pathogenesis of psoriasis with HIV in general. HIV-associated psoriasis can be clinically confusing because several comorbid skin disorders in patients with HIV can mimic psoriasis. Phenotypic variants such as a Reiter's syndrome or fulminant erythroderma provide diagnostic clues to underlying immunodeficiency. The management of moderate and severe HIV-associated psoriasis is challenging, although patients typically improve with highly active antiretroviral therapy. Conventional systemic treatments might be contraindicated or need dose adjustment to avoid toxicity. New biological treatments in this setting are promising and warrant further study.
银屑病是一种慢性丘疹鳞屑性皮肤病，被认为是一种角质形成细胞增殖的 T 细胞介导的自身免疫性疾病。银屑病与 HIV 感染之间的关联似乎有些矛盾，但对 T 细胞亚群、自身免疫、遗传易感性以及与免疫失调相关的感染作用的深入了解，可能会阐明我们对 HIV 相关银屑病发病机制的总体认识。HIV 相关的银屑病可能在临床上难以识别，因为 HIV 感染者的几种合并皮肤疾病可能类似于银屑病。表型变异，如 Reiter 综合征或暴发性红皮病，为潜在免疫缺陷提供了诊断线索。尽管患者通常会随着高效抗逆转录病毒治疗而改善，但中度和重度 HIV 相关银屑病的治疗具有挑战性。传统的全身治疗可能会有禁忌或需要调整剂量以避免毒性。在这种情况下，新的生物治疗方法很有前景，值得进一步研究。
