GIANT MOLLUSCUM CONTAGIOSUM PRESENTING AS A TUMOR IN AN HIV‐INFECTED PATIENT
GIANT MOLLUSCUM CONTAGIOSUM PRESENTING AS A TUMOR IN AN HIV‐INFECTED PATIENT
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HIV 感染者体内出现巨大传染性软疣，表现为肿瘤
DOI：
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发表时间：
1994
影响因子：
3.6
通讯作者：
J. Díaz
中科院分区：
文献类型：
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作者：
R. Izu;D. Manzano;J. Gardeazabal;J. Díaz
一名 29 岁的前吸毒者，自 1987 年以来艾滋病毒呈阳性，于 1992 年 1 月向我们咨询，他的面部和头皮上出现肿瘤，导致毁容。 1990年，他患上了神经节结核，同时还注意到面部、手臂和生殖器部位出现了一些直径2-6毫米的小圆顶状丘疹，临床上典型的传染性软疣。通过刮除术和冷冻疗法治疗病变，取得了部分成功。 1991年，他患上食道念珠菌病，同时被诊断为非霍奇金淋巴瘤（IV-D期）。开始化疗（CHOP 方案）。与淋巴瘤的诊断和细胞抑制治疗的开始相一致，他的面部和头皮上出现了肿瘤块形式的融合性丘疹病变，患者出现严重的、毁容性的畸形（图1和图2）。此时，我们发现以下免疫学参数：白细胞4100/mm^（26%淋巴细胞）、CD4=1%（lO/mm^）、CD4/CD8=0.01。活检证实了诊断。组织病理学检查显示棘皮症表皮，伴有强烈的表皮增殖，并伴有充满嗜酸性和透明肿块（亨德森-帕特森小体）的巨大坑，这是典型的传染性软疣，对应于病毒颗粒的胞浆内包涵体（图3）。由于巨型传染性软疣的蔓延，我们考虑过可能的手术治疗，但由于技术困难以及皮肤接触受污染的血液制品传播艾滋病毒的高风险而拒绝了。我们使用液氮（美国 Brymill 公司的 Cry-AcTM，90 秒的 2 个周期）对病变进行积极的冷冻治疗，每周 1 或 2 天，病变的数量和大小部分减少。目前，还没有出现新的病灶。
A 29-year-old ex-drug addict, Hiv-positive since 1987, consulted us in January 1992, presenting with tumoral disfiguring lesions on his face and scalp. He suffered from ganglionar tuberculosis in 1990, and at the same time also noticed a few small, dome-shaped papules, 2-6 mm in diameter, clinically typical for molluscum contagiosum on the face, arms, and the genital region. The lesions were treated with curettage and cryotherapy with partial success. In 1991, he developed candidiasis of the esophagus, and at the same time a nonHodgkin's lymphoma (IV-D stage) was diagnosed. Chemotherapy (CHOP regimen) was started. Coinciding with the diagnosis of lymphoma and the beginning of the cytostatic treatment, confluent papular lesions developed on his face and scalp in the form of tumoral masses with severe, disfigurating dysmorphy of the patient (Figs. 1 and 2). At this time, we found the following immunologic parameters: leukocytes 4100/mm^ (26% lymphocytes), CD4 = 1% (lO/mm^), CD4/CD8 = 0.01. A biopsy confirmed the diagnosis. Histopathologic examination showed an acanthotic epidermis with an intense epidermal proliferation with giant craters full of eosinophilic and hyaline masses (Henderson-Patterson bodies), typical of molluscum contagiosum and corresponding to intracytoplasmic inclusion of viral particles (Fig. 3). Because of the extension of the giant molluscum contagiosum, we thought of possible surgical treatment but rejected this because of technical difficulties and the high risk of HIV transmission from exposure of the skin to contaminated blood products. We treated the lesions with aggressive cryotherapy using liquid nitrogen (2 cycles of 90 s with Cry-AcTM, Brymill Corporation, USA), on 1 or 2 days per week, with a partial decrease in number and size of the lesions. At present, new lesions have not appeared.
与人类免疫缺陷病毒感染相关的皮肤病学发现。
影响因子：
13.8
作者：
Matis,WL;Triana,A;Shapiro,R;Eldred,L;Polk,BF;Hood,AF
通讯作者：
Hood,AF