Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Dermatol. 2022 Jun;49(6):607-614. doi: 10.1111/1346-8138.16352. Epub 2022 Mar 15.
Psoriasis in people living with HIV (PLHIV) has been reported as having particular clinical characteristics. However, most of the source data was derived from descriptive studies in Europe and the USA. This study was conducted to compare the characteristics of psoriasis in PLHIV to general psoriasis patients. We retrospectively reviewed the records of 73 cases of psoriasis in PLHIV and of 232 general psoriasis patients who visited a psoriasis clinic in Bangkok, Thailand. Psoriasis in PLHIV predominated in males (78.1%), with an older age of onset, significantly lower rates of nail involvement and psoriatic arthritis, but higher rates of co-infectious diseases than for general psoriasis patients. A low nadir CD4 T-cell count (<100 cells/μl) and CD4 T-cell count at psoriasis diagnosis were associated with a high body surface area (BSA) involvement. The mean BSA involvement in PLHIV was 24. Although 64.4% (47/73) of the PLHIV had moderate-to-high psoriasis severity, 29.8% of those (14/47) only received topical treatment. Acitretin was the most common drug used. Other therapies were rarely used, and no biologics were administered. In conclusion, psoriasis in PLHIV has several clinical features that differ from general psoriasis. PLHIV tend to receive substandard care for psoriasis, even in upper-middle-income countries.
HIV 感染者（PLHIV）中的银屑病具有特殊的临床特征，这已经有相关报道。然而，大多数原始数据来自欧洲和美国的描述性研究。本研究旨在比较 PLHIV 中银屑病的特征与普通银屑病患者的特征。我们回顾性地分析了在泰国曼谷一家银屑病诊所就诊的 73 例 PLHIV 中银屑病患者和 232 例普通银屑病患者的病历。PLHIV 中银屑病患者以男性为主（78.1%），发病年龄较大，指甲受累和银屑病关节炎的发生率显著较低，但合并传染病的发生率较高。较低的 CD4 细胞最低计数（<100 个/μl）和银屑病发病时的 CD4 细胞计数与较高的体表面积（BSA）受累相关。PLHIV 的平均 BSA 受累为 24。尽管 64.4%（47/73）的 PLHIV 具有中重度至重度银屑病严重程度，但其中 29.8%（14/47）仅接受了局部治疗。阿维 A 酯是最常用的药物。其他治疗方法很少使用，没有使用生物制剂。总之，PLHIV 中的银屑病具有与普通银屑病不同的临床特征。即使在中等偏上收入国家，PLHIV 也往往无法获得标准的银屑病治疗。
