CAJ | 학술논문

患者男,37岁.因全身多发疣状丘疹、斑片20年,外阴和腹股沟糜烂、渗出2个月就诊.皮肤科检查:全身多发、蚕豆大疣状丘疹,部分融合成片.双侧腹股沟及外阴皮损处糜烂、渗液和结痂.外周血淋巴细胞亚群分析示:CD4+T细胞37.2％,CD8+T细胞43.6％,CD4+/CD8+T细胞比值0.85.斑点杂交示:HPV43和66DNA阳性.皮损组织病理:角化过度,表皮疣状增生及假上皮瘤样增生,可见部分凹空细胞,真皮浅层中度淋巴细胞浸润.诊断为疣状表皮发育不良、皮肤感染和细胞免疫功能低下.治疗给予抗感染、肌内注射免疫增强剂和口服阿维A胶囊,治疗15d后外阴和腹股沟皮损表面干燥、变平,并有大量痂屑脱落,而躯干和四肢皮损无明显变化.目前患者仍在随访中.
환자남,37세.인전신다발우상구진、반편20년,외음화복고구미란、삼출2개월취진.피부과검사:전신다발、잠두대우상구진,부분융합성편.쌍측복고구급외음피손처미란、삼액화결가.외주혈림파세포아군분석시:CD4+T세포37.2％,CD8+T세포43.6％,CD4+/CD8+T세포비치0.85.반점잡교시:HPV43화66DNA양성.피손조직병리:각화과도,표피우상증생급가상피류양증생,가견부분요공세포,진피천층중도림파세포침윤.진단위우상표피발육불량、피부감염화세포면역공능저하.치료급여항감염、기내주사면역증강제화구복아유A효낭,치료15d후외음화복고구피손표면간조、변평,병유대량가설탈락,이구간화사지피손무명현변화.목전환자잉재수방중.
A 37-year-old male was hospitalized due to widespread verrucous papules and patches over the body surface for over 20 years as well as erosive and exudative lesions in the inguinal and vulvar regions for two months.Skin examination revealed numerous round or polygonal,bean-sized verrucous papules on the face,trunk and extremities,with some coalescing into patches.The lesions on bilateral inguinal and vulvar areas were erosive and exudative with dirty crusts.Analysis of peripheral blood lymphocyte subsets showed that CD4 + T cells amounted to 37.2％,CD8+ T cells 43.6％,and the CD4+/CD8+ T cell ratio was 0.85.The tissue specimen was positive for human papillomavirus (HPV) 43 and 66 DNA by dot-blot hybridization.Histopathological examination indicated hyperkeratosis,verrucous hyperplasia and pseudo-epitheliomatous hyperplasia of the epidermis with the presence of some koilocytes,and moderate infiltration of the upper dermis with lymphocytes.He was diagnosed with epidermodysplasia verruciformis and cutaneous infection with non-specific cellular immune dysfunction,and given anti-infection therapy,intramuscular immunoenhancing agents and oral acitretin.After 15 days of treatment,the condition in the vulval and inguinal region greatly improved with shedding of crusts and desquamation,but the lesions on the trunk and extremities experienced no obvious changes.At the time of this writing,the patient was still followed up.