HIV-associated psoriasis
| Autor: | Andrey Mamkin, Igor Mamkin, Sundaram V Ramanan |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Efavirenz Anti-HIV Agents Lymphocyte Population Human immunodeficiency virus (HIV) HIV Infections medicine.disease_cause chemistry.chemical_compound Acquired immunodeficiency syndrome (AIDS) Psoriasis Internal medicine Antiretroviral Therapy Highly Active medicine Humans education education.field_of_study business.industry virus diseases medicine.disease Infectious Diseases medicine.anatomical_structure chemistry Steroids business Viral load CD8 |
| Zdroj: | The Lancet. Infectious diseases. 7(7) |
| ISSN: | 1473-3099 |
| Popis: | A 43-year-old man with an established diagnosis of advanced HIV infection presented with severe psoriasis aff ecting the entire body (fi gure, A). He had not taken antiretroviral treatment for several months and had failed to keep several scheduled appointments. The discomfort of his skin ailment resulted in his return to the hospital. Laboratory examination revealed a CD4+ lymphocyte cell count of 4 cells per μL, CD8+ lymphocyte cell count of 564 cells per μL, CD4+/CD8+ ratio of 0·02, and viral load of 8000 copies per μL. While in the hospital the patient was treated with steroids and highly active antiretroviral therapy (HAART) with efavirenz and lamivudine-zidovudine. The patient’s psoriasis improved markedly over the course of the next 5 days (fi gure, B). During the next year the patient had two admissions to the hospital with similar symptoms and was given the same treatment with excellent results. The prevalence of psoriasis in patients with HIV is approximately 5–6% and is no higher than in the general population. However, patients with HIV infection often present with more severe clinical manifestations of psoriasis than the non-HIV population and treatment is usually diffi cult. Some patients with HIV-associated psoriasis have pre-existing psoriasis, whereas others develop it with the progression to AIDS. Pre-existing psoriasis can undergo severe exacerbation in HIV infection, and psoriasis reportedly becomes more severe with progression of immunodefi ciency. Because the psoriasis is mediated by activated T cells, the association of HIV infection and psoriasis appears paradoxical. It has been postulated that immunodysregulation resulting from HIV infection could trigger psoriasis. Treatment of HIV infection with HAART partly corrects the immune defect caused by chronic HIV infection. This case emphasises the importance of strict adherence to HAART in patients with coexisting HIV infection and psoriasis. It is paradoxical that, although drugs that target T lymphocytes are eff ective in psoriasis, the condition is exacerbated by HIV infection. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|