【摘要】 患者男,22岁。发热1个月,头面部及上肢水疱和溃疡,下肢瘀点、瘀斑伴关节痛4 d。多次同性性接触史3年。皮肤科检查:头面部和双上肢皮肤散在黄豆至指甲大的红色斑疹,边界模糊不清,多数皮损表面坏死、溃疡及结痂,伴有脓性渗出物;双侧小腿、踝部及足背皮肤散在米粒至黄豆大的紫红色瘀点及瘀斑。前臂皮损组织病理:真皮内空泡化细胞,小腿皮损组织病理提示白细胞碎裂性血管炎。快速血浆反应素环状卡片实验(RPR)阳性,滴度1∶256,梅毒螺旋体抗体颗粒凝集试验阳性;抗人免疫缺陷病毒(HIV)抗体初筛试验(+),抗HIV抗体确证试验(+);尿蛋白(+)。诊断:艾滋病、梅毒、水痘、过敏性紫癜。更多还原

【Abstract】 A 22-year-old male with a 3-year history of homosexuality suffered from unexplained fever for over a month. In addition to arthralgia, vesicles and ulcers developed on the head and the arms, along with petechiae and ecchymosis on the legs over the last 4 days. Histology of skin from the forearm demonstrated several vacuolar cells in the dermis. Histologic evaluation of the biopsy from the lower leg showed leukocytoclastic vasculitis. Immunological tests showed RPR(1:256), TPPA(+), and HIV(+). Routine urine test was protein(+). The diagnosis was AIDS, syphilis, varicella and anaphylactoid purpura.更多还原