Misago N, Narisawa Y, Matsubara S, Hayashi S
Department of Internal Medicine, Saga Medical School, Japan.
J Dermatol. 1998 Mar;25(3):178-84. doi: 10.1111/j.1346-8138.1998.tb02376.x.
We report the successful treatment with ultraviolet B phototherapy of a patient with HIV-associated eosinophilic pustular folliculitis. We were able to observe the clinical and therapeutic course for about one year and three months. This 35-year-old homosexual Japanese man presented with disseminated, discrete, follicular, erythematous papules with intense pruritus over his face, neck, chest wall, and upper back. Initially, the eruption responded to therapy with topical or oral indomethacin and oral H1 antihistamine. However, the eruption was highly prone to recurrence, and it gradually failed to respond to these therapies. The eruption became chronic and persistent and manifested the excoriated, prurigo-like nodules that are typical of reported pruritic papular eruption, suggesting that this skin disease and HIV-associated eosinophilic pustular folliculitis are two forms of the same disease entity. UVB phototherapy in small doses was very effective for the persistent eruption, and no recurrence of the eruption was noted during or since the six-month maintenance therapy (once a week at a dose equivalent to 0.75 of the minimal erythema dose) (9 months total). No unfavorable side effects have been observed during or after the UVB phototherapy (cumulative UVB doses of 2,320 mJ/cm2).
我们报告了1例HIV相关嗜酸性脓疱性毛囊炎患者采用窄谱中波紫外线（UVB）光疗成功治愈的病例。我们对该患者的临床及治疗过程进行了约一年零三个月的观察。这位35岁的日本同性恋男性患者，面部、颈部、胸壁及上背部出现散在、孤立、毛囊性、红斑性丘疹，并伴有剧烈瘙痒。起初，外用或口服吲哚美辛及口服H1抗组胺药治疗有效。然而，皮疹极易复发，且逐渐对这些治疗无反应。皮疹转为慢性且持续存在，并出现了已报道的瘙痒性丘疹性皮疹典型的抓痕、痒疹样结节，提示这种皮肤病与HIV相关嗜酸性脓疱性毛囊炎是同一疾病实体的两种形式。小剂量UVB光疗对持续性皮疹非常有效，在为期6个月的维持治疗期间（每周1次，剂量相当于最小红斑量的0.75倍）及之后（共9个月）均未出现皮疹复发。在UVB光疗期间及之后均未观察到不良副作用（累积UVB剂量为2320 mJ/cm2）。
