Ichihashi N, Seishima M, Takahashi T, Muto Y, Kitajima Y
Department of Dermatology, Gifu University School of Medicine, Japan.
J Dermatol. 1995 Jun;22(6):428-33. doi: 10.1111/j.1346-8138.1995.tb03418.x.
A 63-year-old man was referred to our department on September 14, 1992, because of multiple red papules with severe itching. Pruritic papular eruption (PPE) in a human immunodeficiency virus (HIV)-infected patient was diagnosed based on the histological findings, the reduction in CD4, and positive results for HIV antibody. In September of 1993, papules and erythematous plaques with scales appeared on both the palms and soles. The erythema was pruritic and spread gradually to the extremities and trunk. These plaques with erythema and scales are similar to those of the psoriatic lesions seen in Reiter's syndrome, although the HLA typing was not B27. Immunohistopathological findings of the papules of PPE and plaques of psoriasiform lesions showed that perivascularly infiltrated cells in the dermis were mostly lymphocytes. The lymphocytes in PPE were positive for CD45 and negative for CD3, CD43, and CD45RO, but the lymphocytes in psoriasiform lesions were positive for CD45, CD3, and CD43. Moreover, 20-30% of these lymphocytes were also intensely positive for CD45RO. These observations were similar to those obtained in the lesional skin of HIV-negative psoriasis, suggesting that there were no significant immunohistopathological differences in the abnormality of local cellular immunity related to the formation of psoriasiform lesions in HIV-negative psoriasis and HIV-positive psoriasis.
一名63岁男性于1992年9月14日因多处红色丘疹伴剧烈瘙痒被转诊至我科。根据组织学检查结果、CD4降低以及HIV抗体检测呈阳性，诊断为人类免疫缺陷病毒（HIV）感染患者的瘙痒性丘疹性皮疹（PPE）。1993年9月，手掌和脚底出现丘疹及伴有鳞屑的红斑。红斑伴有瘙痒，并逐渐蔓延至四肢和躯干。这些伴有红斑和鳞屑的斑块与赖特综合征中所见的银屑病皮损相似，尽管HLA分型并非B27。PPE丘疹及银屑病样皮损斑块的免疫组织病理学检查结果显示，真皮内血管周围浸润的细胞主要为淋巴细胞。PPE中的淋巴细胞CD45呈阳性，而CD3、CD43和CD45RO呈阴性，但银屑病样皮损中的淋巴细胞CD45、CD3和CD43呈阳性。此外，这些淋巴细胞中有20% - 30%的细胞CD45RO也呈强阳性。这些观察结果与HIV阴性银屑病患者皮损中的观察结果相似，表明在HIV阴性银屑病和HIV阳性银屑病中，与银屑病样皮损形成相关的局部细胞免疫异常在免疫组织病理学上并无显著差异。
