【摘要】 患者男,52岁。口腔疼痛性溃疡2个月,全身散发水肿性红斑、斑块伴疼痛和瘙痒1周。皮肤科情况:颜面、躯干及四肢可见散在分布浸润性水肿性红斑及斑块,界清,部分融合,呈环状或类圆形,部分表面可见绿豆大丘疹,似水疱,部分皮疹破溃并结痂。鼻端、舌尖及舌背可见多个浅溃疡,基底潮红,上覆厚层黄白色伪膜样物。入院后按Sweet综合征对症治疗,皮损无改善,继续有新发皮损,发热加重。刮取患者舌部溃疡伪膜样分泌物镜检发现真菌菌丝,培养鉴定为白念珠菌。采用流式细胞术分析外周血发现淋巴细胞亚群Th/Ts(CD4~+/CD8~+)为0.00,HIV抗体初筛实验与确证实验均呈阳性。修正诊断:获得性免疫缺陷综合征。更多还原

【Abstract】 A 52-year-old male presented with oral ulcers for 2 months and with pruritic erythema and plaques over his body for 1 week. Dermatologic examination: lots of edematous erythema in different sizes with clear boundary were scattered on his face,trunk and limbs. Some skin lesions were ring-like or quasi-circular. There were bean-sized,vesicle-like papules on some of these lesions,and ulcers and crust on the other. Some shallow ulcers with thick yellow-white pseudomembrane were under his nasal tip and on his tongue. His skin lesions were not improved after treatment as Sweet’s syndrome at the beginning. On the other hand,he felt more uncomfortable and fever appeared. The pseudomembrane from his ulcers on his tongue was checked and Candida albicans was identified. His peripheral blood was tested by flow cytometry and disclosed the ratio of CD4~+T lymphocytes to CD8~+T lymphocytes was 0. 00. His primary screen for HIV antibody was positive and it was verified. He was finally diagnosed as acquired immune deficiency syndrome( AIDS).更多还原