Muñoz-Pérez M A, Rodriguez-Pichardo A, Camacho F, Colmenero M A
Department of Dermatology, Virgen Macarena Hospital, School of Medicine of Seville, Spain.
Br J Dermatol. 1998 Jul;139(1):33-9. doi: 10.1046/j.1365-2133.1998.02310.x.
Several prospective studies on dermatological findings in human immunodeficiency virus (HIV) type 1 infected patients have been published, mostly in populations in which the predominant risk factor for HIV infection is homosexuality. We attempted to identify cutaneous diseases associated with HIV-1 infection and to assess disease progression in a cohort of Spanish patients in whom the predominant cause of HIV infection was intravenous drug abuse. We prospectively examined 1161 HIV-1-positive patients for 38 months. Seventy-four per cent of patients were intravenous drug abusers, whereas heterosexual contact was the only risk factor in 14% and homosexuality in 9%. Centers for Disease Control stage II disease predominated (51%), whereas stage IV disease was less frequent (39%). The mean CD4 count was 353/mm3. We took patients' past and present medical history and performed a complete physical examination as well as taking photographs and carrying out the necessary diagnostic procedures. CD4 counts/mm3 were measured at each visit. A diagnosis of cutaneous disease was made in 799 patients (69%). Oral candidiasis and seborrhoeic dermatitis were the most common skin disorders, followed by xerosis, drug eruptions, dermatophytosis and the papular eruption of acquired immunodeficiency syndrome. Condyloma acuminatum, herpes zoster and herpes simplex were the most frequent viral infections. Conditions that have a statistically significant association with advanced stage and low CD4 levels include drug eruptions, xerosis, light reactions, diffuse alopecia, herpes simplex, oral candidiasis, psoriasis, oral hairy leucoplakia, molluscum contagiosum, Kaposi's sarcoma, furuncles, candidal intertrigo, folliculitis and ungual infection, as well as onychomycosis and tinea pedis or manuum. Dermatoses commonly associated with homosexuality, such as Kaposi's sarcoma and oral hairy leucoplakia, were rare in our patients.
已经发表了几项关于1型人类免疫缺陷病毒（HIV）感染患者皮肤病学表现的前瞻性研究，大部分研究针对的是HIV感染主要危险因素为同性恋的人群。我们试图确定与HIV-1感染相关的皮肤疾病，并评估一组以静脉注射毒品为HIV感染主要原因的西班牙患者的疾病进展情况。我们对1161名HIV-1阳性患者进行了为期38个月的前瞻性检查。74%的患者为静脉注射毒品者，而异性接触是14%患者的唯一危险因素，同性恋是9%患者的唯一危险因素。疾病控制中心II期疾病占主导（51%），而IV期疾病较少见（39%）。平均CD4细胞计数为353/mm³。我们询问了患者过去和现在的病史，进行了全面的体格检查，拍摄了照片并进行了必要的诊断程序。每次就诊时均测量CD4细胞计数/mm³。799名患者（69%）被诊断患有皮肤疾病。口腔念珠菌病和脂溢性皮炎是最常见的皮肤疾病，其次是皮肤干燥、药物疹、皮肤癣菌病和获得性免疫缺陷综合征的丘疹性皮疹。尖锐湿疣、带状疱疹和单纯疱疹是最常见的病毒感染。与晚期和低CD4水平有统计学显著关联的疾病包括药物疹、皮肤干燥、光反应、弥漫性脱发、单纯疱疹、口腔念珠菌病、银屑病、口腔毛状白斑、传染性软疣、卡波西肉瘤、疖、念珠菌擦烂、毛囊炎和甲感染，以及甲癣和足癣或手癣。在我们的患者中，通常与同性恋相关的皮肤病，如卡波西肉瘤和口腔毛状白斑很少见。
