Devesa Parente Joana Alexandra, Dores José Alberto Machado, Aranha João Manuel Pires
Department of Dermatology, Santarém District Hospital EPE, Portugal.
Acta Dermatovenerol Croat. 2012;20(4):260-2.
We report a case of a 26-year-old Caucasian male presented with 8-month history of asymptomatic erythematous papulonodular lesions symmetrically located on the face, trunk and limbs. Histopathologic examination revealed granulomas with histiocytes arranged in a palisading pattern around the foci of necrobiotic collagen with mucin deposition, and transepidermal and transfollicular elimination of degenerated collagen bundles. These histopathologic findings were compatible with perforating granuloma annulare. Three months later, the patient was admitted with the diagnosis of sepsis secondary to a gastroenteritis dyeing on the fourth day of presentation. Serologic tests for antibody to human immunodeficiency virus (HIV) performed at this time were positive establishing the diagnosis of acquired immunodeficiency syndrome (AIDS). Atypical variants of granuloma annulare including perforating types might be associated with AIDS. The course and presentation of granuloma annulare might be modified by disruption of both antigen presentation and effector cell mechanisms in the HIV-infected patient.
我们报告一例26岁的白种男性患者，其面部、躯干和四肢对称出现无症状性红斑丘疹结节性损害，病史8个月。组织病理学检查显示肉芽肿，组织细胞围绕坏死性胶原灶呈栅栏状排列，伴有黏蛋白沉积，变性胶原束经表皮和经毛囊清除。这些组织病理学表现符合穿通性环状肉芽肿。3个月后，患者因胃肠炎就诊，在就诊第4天诊断为脓毒症，随后入院。此时进行的人类免疫缺陷病毒（HIV）抗体血清学检测呈阳性，确诊为获得性免疫缺陷综合征（AIDS）。环状肉芽肿的非典型变体包括穿通型可能与AIDS有关。在HIV感染患者中，抗原呈递和效应细胞机制的破坏可能会改变环状肉芽肿的病程和表现。
