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[皮肤病与疱疹重叠感染:34例回顾性研究]

[Dermatoses and herpes superinfection: A retrospective study of 34 cases].

作者信息

Seta V, Fichel F, Méritet J-F, Bouam S, Franck N, Avril M-F, Dupin N

机构信息

Service de dermatologie, hôpital Cochin, université Paris Descartes, Assistance publique-Hôpitaux de Paris (AP-HP), pavillon Tarnier, 89, rue d'Assas, 75006 Paris, France.

Service de virologie, hôpital Cochin, université Paris Descartes, Assistance publique-Hôpitaux de Paris (AP-HP), 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.

出版信息

Ann Dermatol Venereol. 2017 Mar;144(3):176-181. doi: 10.1016/j.annder.2017.01.011. Epub 2017 Feb 24.

Abstract

BACKGROUND

Although varicelliform Kaposi eruption is a well-known complication of dermatoses, it has not been widely investigated.

AIM

To investigate features of dermatoses and herpes superinfection in patients hospitalized in a dermatology department.

PATIENTS AND METHODS

We performed a single-centre, retrospective study between 2008 and 2014 that included cases of Kaposi varicelliform eruptions defined by positive PCR of an unconventional site of herpetic recurrence in a setting of active dermatitis. A record was compiled of each case giving details of the history, clinical and laboratory findings, therapeutic data and outcome.

RESULTS

Thirty-four cases of Kaposi varicelliform eruptions in 30 subjects were studied. Mean age at diagnosis was 63.3±24.2 years. The underlying dermatoses were as follows: 7 pemphigus, 6 bullous pemphigoid, 3 cicatricial pemphigoid, 3 atopic dermatitis, 1 Darier disease, and 14 other dermatoses. Patients presented with skin (94.1 %) or mucous membrane lesions (62 %), mostly erosive (79 %), vesicular (27 %) or bullous (41 %), often painful (56 %) or pruritic (29 %). At diagnosis, 41.2 % were undergoing systemic immunotherapy and 24 % were on topical corticosteroids. PCR was positive for HSV1 in 20 cases and for HSV2 in 4 cases, and indeterminate in 10 cases. Lymphocytopenia was seen in 59 % of cases. The majority of patients received treatment. Nine patients experienced at least one relapse.

CONCLUSION

Our study confirms the over-representation not only of the expected dermatoses (pemphigus and atopic dermatitis), but also of others such as pemphigoid and acute dermatoses; these results should be investigated in a more systematic prospective study.

摘要

背景

尽管水痘样卡波西疹是一种广为人知的皮肤病并发症,但尚未得到广泛研究。

目的

调查皮肤科住院患者皮肤病及疱疹重叠感染的特征。

患者与方法

我们在2008年至2014年间进行了一项单中心回顾性研究,纳入了在活动性皮炎背景下疱疹复发非常规部位PCR检测呈阳性所定义的水痘样卡波西疹病例。记录了每个病例的病史、临床和实验室检查结果、治疗数据及转归详情。

结果

对30名受试者的34例水痘样卡波西疹病例进行了研究。诊断时的平均年龄为63.3±24.2岁。基础皮肤病如下:天疱疮7例,大疱性类天疱疮6例,瘢痕性类天疱疮3例,特应性皮炎3例, Darier病1例,其他皮肤病14例。患者出现皮肤病变(94.1%)或黏膜病变(62%),大多为糜烂性(79%)、水疱性(27%)或大疱性(41%),常伴有疼痛(56%)或瘙痒(29%)。诊断时,4l.2%的患者正在接受全身免疫治疗,24%的患者正在使用外用糖皮质激素。20例PCR检测HSV1呈阳性,4例HSV2呈阳性,10例结果不确定。59%的病例出现淋巴细胞减少。大多数患者接受了治疗。9例患者至少复发1次。

结论

我们的研究证实,不仅预期的皮肤病(天疱疮和特应性皮炎),而且其他皮肤病如类天疱疮和急性皮肤病的比例过高;这些结果应在更系统的前瞻性研究中进行调查。

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