Sadick N S
Department of Medicine, Cornell University Medical College, New York, New York.
Int J Dermatol. 1993 Jan;32(1):33-8. doi: 10.1111/j.1365-4362.1993.tb00960.x.
The present study reports the incidence of trichocutaneous disorders studied in 500 patients infected with HIV 1 in a large university-based setting. Correlation of these findings with immunologic function at the time of diagnosis is presented. Unusual presentations and therapeutic interventions are discussed. Prognosis as related to various trichocutaneous disorders is elaborated.
All patients in this study were HIV 1 positive by Western blot assay. T-cell subsets were evaluated by monoclonal antibodies against T-cell surface markers. Hair disorders were analyzed by means of light hair pull test, hair mount, polarizing microscopy, trichogram, scalp biopsy, and cultures for bacteria, fungi, and mycobacteria as indicated. Trichologic manifestations were classified based upon immunologic correlation of absolute level of helper T cells/mm3.
The majority of hair disorders in the study population occurred with helper T cell numbers of less than 150/mm3. Papulosquamous problems including seborrheic dermatitis and psoriasis were most commonly noted followed by disorders of cell growth cycle regulation and trichokeratinization, i.e., telogen effluvium and loose anagen syndrome.
Multiple trichocutaneous disorders occur in the setting of retroviral infection. Most of these disorders occur in the setting of progressive immunoincompetence. The awareness of the disorders described here will aid the clinician in both the recognition and management of pilar aberrations in the appropriate clinical setting.
本研究报告了在一所大型大学附属医院中对500例感染HIV-1患者的毛发皮肤疾病发病率。呈现了这些发现与诊断时免疫功能的相关性。讨论了不寻常的表现及治疗干预措施。阐述了与各种毛发皮肤疾病相关的预后情况。
本研究中所有患者经蛋白质印迹法检测HIV-1均呈阳性。通过针对T细胞表面标志物的单克隆抗体评估T细胞亚群。根据需要，通过轻拉毛发试验、毛发挂载、偏振显微镜检查、毛发图谱分析、头皮活检以及细菌、真菌和分枝杆菌培养对毛发疾病进行分析。根据辅助性T细胞/mm³绝对水平的免疫相关性对毛发学表现进行分类。
研究人群中大多数毛发疾病发生在辅助性T细胞数量低于150/mm³时。最常见的丘疹鳞屑性问题包括脂溢性皮炎和银屑病，其次是细胞生长周期调节和毛发角化异常，即休止期脱发和生长期松动综合征。
逆转录病毒感染时会出现多种毛发皮肤疾病。这些疾病大多发生在进行性免疫功能不全的情况下。了解此处描述的疾病将有助于临床医生在适当的临床环境中识别和处理毛发异常。
