Résumé
Psoriasis is a chronic inflammatory skin disease that involves immune-mediated cutaneous inflammation and keratinocyte hyperproliferation. Psoriasis in patients with HIV responds poorly to treatment and has a high morbidity rate, thus posing a challenge to clinicians. Until now, there have been no documented cases of acitretin therapy for HIV-associated psoriasis in Korea. Here, we report a case of safe and successful therapy with acitretin in a 52-year-old man with HIV-associated psoriasis that responded poorly to previous treatments including steroids and ultraviolet B phototherapy. We also review the relevant literature.
Sujets)
Humains , Adulte d'âge moyen , Acitrétine , VIH (Virus de l'Immunodéficience Humaine) , Inflammation , Kératinocytes , Corée , Photothérapie , Psoriasis , Maladies de la peau , StéroïdesRésumé
A 46-year-old man was admitted to our hospital because of a fever of unknown origin. The patient had a skin rash, arthralgia, and hepatosplenomegaly. Laboratory tests showed leukemoid leukocytosis, a high serum ferritin level (31,200 ng/mL), and abnormal liver function tests. He was initially diagnosed with adult-onset Still's disease (AOSD). However, imaging studies incidentally detected a cold abscess involving the 11th thoracic vertebra. A biopsy of the abscess revealed histologically granulomatous caseous necrosis, positive for M. tuberculosis by polymerase chain reaction. We present a patient with musculoskeletal tuberculosis (TB) that clinically mimicked AOSD. In TB-endemic countries, extrapulmonary TB should be included in the differential diagnosis of AOSD.
Sujets)
Humains , Adulte d'âge moyen , Abcès , Arthralgie , Biopsie , Diagnostic différentiel , Exanthème , Ferritines , Fièvre d'origine inconnue , Hyperleucocytose , Tests de la fonction hépatique , Mycobacterium tuberculosis , Nécrose , Réaction de polymérisation en chaîne , Rachis , Maladie de Still débutant à l'âge adulte , TuberculoseRésumé
Amebic liver abscess (ALA) has been diagnosed in travelers to endemic areas or in patients with immunosuppression secondary to human immunodeficiency virus infection since the late 1990s. Further, it is a rare disease in Korea. ALA should be considered in patients present with fever and right upper quadrant pain along with a risk of exposure to amebiasis. We report an 82-year-old man with symptoms of fever, gross hematuria and severe renal impairment as having amebic liver abscess complicated with the obstruction of the inferior vena cava. Amebic liver abscess was successfully treated with antibiotics alone. Also, hematuria disappeared and renal dysfunction improved after treatment.