Sehgal Virendra N, Verma Prashant, Sharma Sonal
Dermato Venerology (Skin/VD) Center, Sehgal Nursing Home, A/6 Panchwati, Delhi-110 033 India.
Skinmed. 2013 Nov-Dec;11(6):375-7.
A 58-year-old, nonalcoholic, nonsmoker, official in private enterprise presented with a confirmed case of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and an itchy, violaceous skin eruption over the lower part of the left leg. He noticed a change in the color and texture of the skin for the first time 2 years ago. Ever since that time, the eruptions had insidiously progressed. He was started on highly active antiretroviral therapy (HAART), comprising 600 mg of zidovudine, 300 mg of lamivudine, and 600 mg of efavirenz for the past year. Despite the therapy, the lesions continued to progress. He claimed to be very compliant with therapy. In addition, he developed pulmonary tuberculosis during the course of the disease. Accordingly, he was treated with a daily schedule' of antitubercular therapy, comprising 450 mg of rifampicin, 300 mg of isoniazid, 1500 mg of pyrazinamide, and 800 mg of ethambutol for 9 months. He experienced a significant loss of weight and appetite. The patient was a divorcee but refused to divulge any details of his married life after a considerate and focused discussion by a trained counselor on HIV/AIDS. He emphatically denied any extramarital sexual contact, blood transfusion, and surgery in the past. Ultimately, the patient's disease status was defined by HIV viral load (< 20 copy/mL) after obtaining informed consent.
一名58岁的非酒精性、不吸烟的民营企业职员,被确诊感染人类免疫缺陷病毒/获得性免疫缺陷综合征(HIV/AIDS),左腿下部出现瘙痒性紫皮疹。他在2年前首次注意到皮肤颜色和质地的变化。从那时起,皮疹逐渐隐匿发展。在过去一年里,他开始接受高效抗逆转录病毒治疗(HAART),包括600毫克齐多夫定、300毫克拉米夫定和600毫克依非韦伦。尽管进行了治疗,皮损仍持续进展。他声称严格遵守治疗方案。此外,在病程中他还患上了肺结核。因此,他接受了为期9个月的每日抗结核治疗方案,包括450毫克利福平、300毫克异烟肼、1500毫克吡嗪酰胺和800毫克乙胺丁醇。他体重显著减轻,食欲下降。该患者已离婚,但在经过一名训练有素的HIV/AIDS咨询师体贴且专注的讨论后,他拒绝透露其婚姻生活的任何细节。他坚决否认过去有任何婚外性接触、输血和手术史。最终,在获得知情同意后,通过检测HIV病毒载量(<20拷贝/毫升)确定了患者的病情状况。