以带状疱疹为首发症状的艾滋病8例临床分析

Clinical Analysis of Eight Cases AIDS Presented with Herpes Zoster as the Initial Symptom

目的探讨合并有性病、多种皮肤病、嫖娼、多性伴史与以带状疱疹为首发表现的艾滋病患者的特点和关系。方法对2011年3月-2012年2月间诊治的8例以带状疱疹为首发表现的艾滋病患者临床资料进行分析。结果 8例患者中男3例,女5例,年龄26～38岁7例,81岁1例;未婚和丧偶5例,在婚3例。8例一般情况良好,带状疱疹于躯干四肢7例,额面部1例。皮损为大面积群簇性水疱、大疱、血疱,部分融合伴剧烈刺痛。合并非淋菌性尿道(宫颈)炎2例,淋病1例,尖锐湿疣1例,隐性梅毒1例,合并复发性生殖器疱疹和进展期肺结核1例。同时合并单纯疱疹、脂溢性皮炎1例;同时合并尖锐湿疣、非淋菌性宫颈炎及隐性梅毒1例。8例患者有多性伴或嫖娼史,无输血史、吸毒史,经过治疗后7例治愈,1例后遗神经痛3个月。结论对于带状疱疹患者,文化程度较低、不在婚者、有多性伴史、嫖娼史、过去和现时有性病史者,或多种反复发作的皮肤病、肺结核,特别是服务行业年轻女性、性活跃者,都应行HIV初筛检查,以免漏诊。

Objective To profile characteristics and relationships of patients with AIDS combined with venereal diseases, various skin diseases, prostitution, history of multiple sex partners and has first symptom of herpes zoster. Methods Analyze clinical data of 8 patients with AIDS whose first symptom was herpes zoster, diagnosed and treated during the period from March 2011 and February 2012. Results Among the 8 patients, there are 3 males and 5 females, 7 cases were aged between 26 and 38, and 1 case was aged 81 ; 5 cases were unmarried and widowed, and 3 cases were married. 8 cases were generally in a good condition, 7 cases had herpes zoster on four limbs of their body, and 1 case had herpes zoster on the face. Skin lesions were large areas of clusters of blisters, bulla and blood blister, part of which was combined with severe tingling. 2 cases had non-gonococeal urethritis （cervical） inflammation, 1 case had gonorrhea, 1 ease had condyloma, 1 case had latent syphilis, and 1 case had combined recurrent genital herpes and advanced tuberculosis. At the same time, 1 case had combined herpes simplex and seborrheic dermatitis; and 1 case had condyloma, non-gonococcal cervicitis and latent syphilis. 8 patients have history of multiple sexual partners or prostitution, without history of blood transfusion and drug abuse. 7 cases were cured after treatment, while 1 case had postherpetic neuralgia for 3 months. Conclusion Patients with herpes zoster, with lower level of education, unmarried, history of multiple sexual partners, history of prostitution, history of venereal diseases in the past and at present, or various recurrent skin diseases and tuberculosis, especially young females in service industry and people who are sexually active should have HIV screening examination to avoid missed diagnosis.