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一名感染人类免疫缺陷病毒(HIV)的患者,在局部使用维甲酸耐药后,采用20%局部乙醇酸治疗传染性软疣。

Molluscum Contagiosum in HIV Patient Treated with 20% Topical Glycolic Acid After Resistance with Topical Tretinoin.

作者信息

Achdiat Pati Aji, Andiani Syafira, Hindritiani Reti, Gondokaryono Srie Prihianti, Nuzuliyah Gempita, Usman Hermin Aminah, Maharani Retno Hesty

机构信息

Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia.

Department of Anatomical Pathology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.

出版信息

Clin Cosmet Investig Dermatol. 2023 Sep 29;16:2749-2755. doi: 10.2147/CCID.S423304. eCollection 2023.

Abstract

Molluscum contagiosum (MC) is a benign papular skin infection caused by Molluscum contagiosum virus (MCV). Over the past 30 years, the incidence of MK has continued to increased association with sexually transmitted infections and human immunodeficiency virus (HIV) infection. The incidence of MC in HIV patients is quite high at 5-8%. Until now there is no standard therapy used for the treatment of MC in patients with HIV. In HIV patients, anti retro viral therapy (ARV) is the main therapy with several other additional therapies such as cantaridin, chemical peeling agents such as glycolic acid (20-70%) and trichloroacetic acid (20-100%), cryosurgery, electrosurgery, incision, lactic acid, laser surgery, podophyllin, retinoic acid, and urea. There have been no studies regarding the administration of topical 20% glycolic acid in MC patients. We report a case of MC in an HIV patient who was treated with 20% topical glycolic acid after failing treatment with topical tretinoin. The diagnosis was made clinically, cytologically, and histopathologically, a white mass was found on compression of the lesion and Henderson-Paterson bodies. The lesions on the face, arms, and legs were given glycolic acid lotion 20% which was applied once a day at night. The lesions started to show responses to the treatment at week 6th as some of the MC papules became hyperpigmented macules. The side effects of therapy that appeared were itching and hyperpigmentation. Topical 20% glycolic acid can be used for MC therapy with minimal side effects, easy to apply and safe.

摘要

传染性软疣(MC)是由传染性软疣病毒(MCV)引起的一种良性丘疹性皮肤感染。在过去30年中,MC的发病率持续上升,与性传播感染和人类免疫缺陷病毒(HIV)感染有关。HIV患者中MC的发病率相当高,为5%-8%。到目前为止,尚无用于治疗HIV患者MC的标准疗法。在HIV患者中,抗逆转录病毒疗法(ARV)是主要疗法,还有其他几种辅助疗法,如斑蝥素、化学剥脱剂,如乙醇酸(20%-70%)和三氯乙酸(20%-100%)、冷冻手术、电外科手术、切开、乳酸、激光手术、鬼臼毒素、维甲酸和尿素。目前尚无关于对MC患者使用20%乙醇酸外用的研究。我们报告一例HIV患者的MC,在用外用维甲酸治疗失败后,使用20%乙醇酸外用进行治疗。通过临床、细胞学和组织病理学做出诊断,在病变部位加压时发现白色肿物及亨德森-帕特森小体。面部、手臂和腿部的病变部位给予20%乙醇酸洗剂,每晚涂抹一次。在第6周时病变开始显示出对治疗的反应,一些MC丘疹变成色素沉着斑。出现的治疗副作用是瘙痒和色素沉着。20%乙醇酸外用可用于MC治疗,副作用最小,易于应用且安全。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71a1/10546996/df330944df20/CCID-16-2749-g0001.jpg

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