Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy.
Department of Translational and Precision Medicine, "Sapienza" University of Rome, Rome, Italy.
BMC Infect Dis. 2020 May 20;20(1):360. doi: 10.1186/s12879-020-05089-1.
To date, very little information is available concerning the relationship between acanthosis nigricans (AN) and infection with human immunodeficiency virus type 1 (HIV-1).
Herein, we report the case of a middle-aged man admitted for fever and progressively worsening dyspnea in the context of an opportunistic pneumonia and firstly diagnosed with acquired immunodeficiency syndrome (AIDS). At the time of diagnosis, physical examination revealed the presence of a palpable, hyperpigmented skin lesion on the left areola with surface desquamation and velvety texture consistent with AN. Of note, the most common primary etiologies related to AN were excluded and the complete regression of the skin lesion was observed once antiretroviral therapy was started.
This is the second report of AN found in patients with AIDS and apparently responsive to prolonged antiretroviral treatment. Possible explanations of this association are still not completely understood, probably related to virus-induced changes in lipid metabolism. Our experience suggests that HIV testing should always be considered in the setting of apparently idiopathic AN.
迄今为止，有关黑棘皮病（AN）与人类免疫缺陷病毒 1 型（HIV-1）感染之间的关系的信息非常有限。
在此，我们报告了一例中年男性患者，因机会性肺炎发热和进行性加重的呼吸困难入院，最初被诊断为获得性免疫缺陷综合征（AIDS）。诊断时，体格检查发现左侧乳晕有可触及的色素沉着皮肤病变，表面有鳞屑，质地如天鹅绒，符合 AN。值得注意的是，排除了与 AN 最常见的原发性病因，并在开始抗逆转录病毒治疗后观察到皮肤病变完全消退。
这是第二例在 AIDS 患者中发现的 AN 病例，并且明显对长期抗逆转录病毒治疗有反应。这种关联的可能解释尚不完全清楚，可能与病毒诱导的脂代谢变化有关。我们的经验表明，在出现明显特发性 AN 的情况下，应始终考虑进行 HIV 检测。
