银屑病患者感染HIV后，有约 2/3 患者皮损迅速恶化。HIV 感染可加重炎症反应，寻常型易转变为脓疱型、关节型及红皮病型，其中关节型多见，且同一患者可同时出现几种类型。
· 脂溢性皮炎是 HIV/AIDS 患者常见的皮肤病，常发生于脸、头皮、胸、背，严重者可泛发全身呈红皮病样。
· HIV/AIDS 患者药疹发病率高于正常人群，常由复方新诺明等药物引起，抗逆转录病毒药物奈韦拉平也容易引起药疹。常见的皮肤黏膜表现为多形性红斑、麻疹样皮疹、Stevens-Johnson 综合征。
· HIV 相关性瘙痒性丘疹表现为散在分布的坚实红色水肿性丘疹，以四肢为主，瘙痒剧烈。
· 光敏性皮炎好发于紫外线指数较高的区域，肤色较深的人种更容易发病。抗逆转录病毒药物、抗结核药物、磺胺类、四环素类药物会使得使光敏性皮炎加剧。
三、肿瘤性皮肤病
· 卡波西肉瘤初发为斑丘疹，进而发展为丘疹，丘疹互相融合，扩大成为隆起结节，可累及多个部位[15]。
· 淋巴瘤的发生与免疫抑制相关，HIV/AIDS 患者淋巴瘤患病率较正常人高。霍奇金淋巴淋、非霍奇金淋巴瘤、皮肤T细胞淋巴瘤是HIV患者常见的淋巴瘤[16]。
而在其中，HIV感染早期最最常见的小红疹就是典型的病毒性皮疹了。
它有着几个显著的特点：
· 在高危行为后约2周左右出现
· 是发烧过后或者发烧期间起的小红疹
· 在皮肤表面不突起，按一下红色会消退
· 主要分布在四肢、前胸和颈面部，连接成片，多呈对称
经过一番仔细比对，我发现，我根本就不是什么HIV小红疹！
因为我的小红疹在4周后才出现，突出皮肤，就分布在手臂上零星的两颗，也不对称。而且，HIV检测结果也是阴性！
我实在是太开心了，害我白白担心这么久，终于守得明月见云开了！
但我以后，再也不敢乱来！！！
数据来源：
[1] Sud N, Shanker V, Sharma A, et al. Mucocutaneous manifestations in 150 HIV-infected Indian patients and their relationship with CD4 lymphocyte counts[J]. Int J STD AIDS, 2009, 20(11): 771-774.
[2] Raju PV, Rao GR, Ramani TV, et al. Skin disease: clinical indicator of immune status in human immunodeficiency virus ( HIV) infection[J]. Int Dermatol, 2005, 44 (8): 646-649.
[3] Qian He, Yuan Ding, Wei Zhou, et al. Clinical features of pulmonary cryptococcosis among patients with different levels of peripheral blood CD4 T lymphocyte counts[J]. Bmc Infectious Diseases, 2017, 17(1):768.
[4] Barnabas RV, Celum C. Infectious co-factors in HIV-1 transmission herpes simplex virus type-2 and HIV-1: new insights and interventions[J]. Curr HIV Res, 2012, 10(3) : 228-237.
[5] Garman ME, Tyring SK. The cutaneous manifestations of HIV infection[J]. Dermatol Clin, 2002, 20(2): 193-208.
[6] Paulo Henrique Braz-Silva, Juliana Lucena Schussel, Karen López Ortega, et al. Oral lesions as an important marker for HIV progression[J]. Dermatol Online J, 2017, 23(9): 13.[7] Aizezi Yasen, Rossana Herrera, Kristina Rosbe,等. Release of HIV-1 sequestered in the vesicles of oral and genital mucosal epithelial cells by epithelial-lymphocyte interaction[J]. Plos Pathogens, 2017, 13(2):e1006247.
[8] Venkatesan P, Perfect JR, Myers SA. Evaluation and management offungal infections in immunocompromised patients [J]. Dermatol Ther, 2005, 18(1) : 44-57.
[9] Rani Mathew, V Sreedevan. Erythroderma: A clinicopathological study of 370 cases from a tertiary care center in Kerala[J]. Indian J Dermatol Venereol Leprol, 2017, 83(5):625.
[10] Mi Kwon, Rebeca Bailén, Pascual Balsalobre, et al. Allogeneic stem cell transplantation in HIV-1 infected patients with high-risk hematological disorders[J]. AIDS, 2019, 33(9):1.
[11] Resneck JS Jr, Van Beek M, Furmanski L, et al. Etiology of pruritic papular eruption with HIV infection in Uganda [J]. JAMA, 2004, 292( 21) : 2614-2621.
[12] Boonchai W, Laohasrisakul R, Manonukul J, et al. Pruritic popular eruption in HIV seropositive patients: a cutaneous marker for immunosuppression [J]. Int J Dermatol, 1999, 38(5) : 348-350.
[13] Bilu D, Mamelak AJ, Nguyen RH, et al. Clinical and epidemiologic
characterization of photosensitivity in HIV-positive individual [J]. Photodermatol Photoimmunol Photomed, 2004, 20(4): 175-183.[14] Karen McGuigan, Charles J McGuigan. Chronic skin disorders negatively impact women's quality of life and sexual function[J]. Evidence-Based Nursing, 2019, 22(4):ebnurs-2018-103040.
[15] Isaí Medina-Piñón, Martín Wah-Suárez, Luis Arturo Acosta-Calderón, et al. Extensive AIDS-associated Kaposi's sarcoma[J]. International Journal of Infectious Diseases, 2017, 67(C):137-138..[16] Anupriya Dutta, Hajime Uno, Alex Holman, et al. Long-term nitrite inhalant exposure and cancer risk in men who have sex with men: a prospective cohort study[J]. Aids, 2017, 31(8):1169-1180.
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