艾滋病并发Addison病1例并文献复习

AIDS accompanied by Addison’s disease:a case report and literature reviews

报告1例艾滋病并发Addison病。患者男,40岁。HIV抗体阳性1年余,随后全身皮肤变黑,伴恶心和呕吐。体格检查:精神弱,体形消瘦。皮肤科检查:唇、口腔黏膜和牙龈可见蓝黑色斑疹及斑块,全身皮肤呈弥漫性黑褐色色素沉着,以额部、面部、四肢关节伸侧及双手足指(趾)为重。皮损组织病理检查:表皮轻度角化亢进,上皮角下延,基底层及棘层可见大量色素沉着,真皮浅层可见少量噬黑素细胞。实验室检查:血皮质醇明显降低,促肾上腺皮质激素(ACTH)升高。诊断:艾滋病并发Addison病。予糖皮质激素治疗后皮损好转。

A case of AIDS accompanied by Addison’s disease is reported. A 40-year-old man who was positive for HIV antibody over a year presented with whole skin darkening, nausea and vomiting. The patient appeared to be weak and thin. Physical examination showed blue-black macules and patches on the lip, oral mucosa and gum. The skin of the whole body was diffusely dark brown, especially the forehead, face, the extension side of limb joints, digits of hands and feet. Histopathological examination revealed hyperkeratosis and elongation of rete ridges with basal pigmentation. A few melanophages were present in the superficial dermis. The level of serum cortisol was significantly decreased, and the level of ACTH was increased. The diagnosis of AIDS with Addison’s disease was made. The patient’s symptom was improved after glucocorticoid therapy.