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患者男,52岁。口腔疼痛性溃疡2个月,全身散发水肿性红斑、斑块伴疼痛和瘙痒1周。皮肤科情况:颜面、躯干及四肢可见散在分布浸润性水肿性红斑及斑块,界清,部分融合,呈环状或类圆形,部分表面可见绿豆大丘疹,似水疱,部分皮疹破溃并结痂。鼻端、舌尖及舌背可见多个浅溃疡,基底潮红,上覆厚层黄白色伪膜样物。入院后按Sweet综合征对症治疗,皮损无改善,继续有新发皮损,发热加重。刮取患者舌部溃疡伪膜样分泌物镜检发现真菌菌丝,培养鉴定为白念珠菌。采用流式细胞术分析外周血发现淋巴细胞亚群Th/Ts(CD4~+/CD8~+)为0.00,HIV抗体初筛实验与确证实验均呈阳性。修正诊断:获得性免疫缺陷综合征。
Male patient, 52 years old. Oral painful ulcer 2 months, systemic edematous erythema, plaque with pain and itching for 1 week. Dermatology: face, trunk and limbs scattered distribution of infiltrative edematous erythema and plaque, clearance, partial fusion, was ring-like or round, part of the surface can be seen Muddy papules, blisters, some rash ulceration and Scabs. The nose, tongue and tongue can be seen a number of shallow ulcers, the basement flushing, overlying thick yellow-white pseudomembranous samples. Symptoms treatment by Sweet syndrome after admission, no improvement of skin lesions, continue to have new hair lesions, increased fever. Scraping patients with tongue ulcer pseudomembranous secretions microscopy found fungal mycelium, culture identified as Candida albicans. Flow cytometry analysis of peripheral blood lymphocyte subsets Th / Ts (CD4 ~ + / CD8 ~ +) was 0.00, HIV antibody screening tests and confirmatory tests were positive. Revised diagnosis: Acquired Immune Deficiency Syndrome.