Baidu
map

艾滋病合并阴囊佩吉特病

2018-01-21 佚名 中华临床感染杂志

患者,男,76岁

【一般资料】

患者,男,76岁

【主诉】

因阴囊右侧皮肤红斑、溃疡8年于2010年7月27日人院。

【现病史】

8年前患者无明显诱因出现阴囊右侧皮肤湿疹样红斑、糜烂伴瘙痒,皮损逐渐扩大,出现破溃、渗液,累及阴茎根部,长期以“湿疹”诊治,效果差。1个月前在外院行阴囊皮肤活检病理示乳腺外佩吉特病,为进一步诊治来我院。患者4年前被确诊为艾滋病,服用拉米夫定(300mg,1次/d),司他夫定(30mg,1次/12h),依非韦仑(600mg,1次/d)抗病毒治疗。患者有糖尿病史20年。

【体格检查】

阴囊右侧有一约200cmx225cm皮损,侵及阴茎右侧近根部1/3处。基底溃疡伴分泌物,周边皮肤质地略硬,有触痛。全身浅表淋巴结无肿大。

【辅助检查】

盆腔电子计算机断层扫描(CT)未发现淋巴结及脏器转移。

【治疗经过】

硬膜外麻醉下行阴囊及阴茎局部皮肤扩大切除术,切除距皮损边缘50cm病变组织,深度达睾丸鞘膜和阴茎白膜,术中快速冰冻检查切缘无癌细胞侵及,直接缝合切口。术后病理诊断:表皮的基底层和深棘层内见大而异型,细胞质透明的佩吉特细胞,呈单个散在或成簇分布;乳腺外佩吉特病A2期(图1,2)。免疫组化染色:囊泡病液体蛋白-15(+),细胞角蛋白-7(+),细胞角蛋白-20(-),细胞角蛋白(+),单克隆鼠抗人细胞角蛋白CAM5.2(+),细胞角蛋白5/6(-),高分子细胞角蛋白(-),多克隆鼠抗S-100(-),HMB45(-),白细胞共同抗原(-),人乳头瘤病毒(-),癌胚抗原(+)。术后一周出院。随访4年,一直服用抗HIV药物(拉米夫定+司他夫定+依非韦伦),未发现复发及远处转移。




版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1633048, encodeId=37f21633048f8, content=<a href='/topic/show?id=cd809e523ce' target=_blank style='color:#2F92EE;'>#阴囊#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97523, encryptionId=cd809e523ce, topicName=阴囊)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1bbc21999394, createdName=vera_1210, createdTime=Tue May 15 20:47:00 CST 2018, time=2018-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281826, encodeId=19de2818266c, content=学习了谢谢分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Thu Jan 25 07:44:56 CST 2018, time=2018-01-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281046, encodeId=d1eb28104659, content=是很好的学习材料.不错.以后会多学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Jan 22 20:17:04 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280969, encodeId=2d5b280969c9, content=很好的文章.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Mon Jan 22 12:08:52 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280752, encodeId=8d5d280e52d7, content=学习了谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Sun Jan 21 19:10:37 CST 2018, time=2018-01-21, status=1, ipAttribution=)]
    2018-05-15 vera_1210
  2. [GetPortalCommentsPageByObjectIdResponse(id=1633048, encodeId=37f21633048f8, content=<a href='/topic/show?id=cd809e523ce' target=_blank style='color:#2F92EE;'>#阴囊#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97523, encryptionId=cd809e523ce, topicName=阴囊)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1bbc21999394, createdName=vera_1210, createdTime=Tue May 15 20:47:00 CST 2018, time=2018-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281826, encodeId=19de2818266c, content=学习了谢谢分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Thu Jan 25 07:44:56 CST 2018, time=2018-01-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281046, encodeId=d1eb28104659, content=是很好的学习材料.不错.以后会多学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Jan 22 20:17:04 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280969, encodeId=2d5b280969c9, content=很好的文章.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Mon Jan 22 12:08:52 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280752, encodeId=8d5d280e52d7, content=学习了谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Sun Jan 21 19:10:37 CST 2018, time=2018-01-21, status=1, ipAttribution=)]
    2018-01-25 大爰

    学习了谢谢分享!!

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1633048, encodeId=37f21633048f8, content=<a href='/topic/show?id=cd809e523ce' target=_blank style='color:#2F92EE;'>#阴囊#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97523, encryptionId=cd809e523ce, topicName=阴囊)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1bbc21999394, createdName=vera_1210, createdTime=Tue May 15 20:47:00 CST 2018, time=2018-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281826, encodeId=19de2818266c, content=学习了谢谢分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Thu Jan 25 07:44:56 CST 2018, time=2018-01-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281046, encodeId=d1eb28104659, content=是很好的学习材料.不错.以后会多学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Jan 22 20:17:04 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280969, encodeId=2d5b280969c9, content=很好的文章.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Mon Jan 22 12:08:52 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280752, encodeId=8d5d280e52d7, content=学习了谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Sun Jan 21 19:10:37 CST 2018, time=2018-01-21, status=1, ipAttribution=)]
    2018-01-22 李东泽

    是很好的学习材料.不错.以后会多学习.

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1633048, encodeId=37f21633048f8, content=<a href='/topic/show?id=cd809e523ce' target=_blank style='color:#2F92EE;'>#阴囊#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97523, encryptionId=cd809e523ce, topicName=阴囊)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1bbc21999394, createdName=vera_1210, createdTime=Tue May 15 20:47:00 CST 2018, time=2018-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281826, encodeId=19de2818266c, content=学习了谢谢分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Thu Jan 25 07:44:56 CST 2018, time=2018-01-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281046, encodeId=d1eb28104659, content=是很好的学习材料.不错.以后会多学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Jan 22 20:17:04 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280969, encodeId=2d5b280969c9, content=很好的文章.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Mon Jan 22 12:08:52 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280752, encodeId=8d5d280e52d7, content=学习了谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Sun Jan 21 19:10:37 CST 2018, time=2018-01-21, status=1, ipAttribution=)]
    2018-01-22 清风拂面

    很好的文章.谢谢分享

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1633048, encodeId=37f21633048f8, content=<a href='/topic/show?id=cd809e523ce' target=_blank style='color:#2F92EE;'>#阴囊#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97523, encryptionId=cd809e523ce, topicName=阴囊)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1bbc21999394, createdName=vera_1210, createdTime=Tue May 15 20:47:00 CST 2018, time=2018-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281826, encodeId=19de2818266c, content=学习了谢谢分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Thu Jan 25 07:44:56 CST 2018, time=2018-01-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281046, encodeId=d1eb28104659, content=是很好的学习材料.不错.以后会多学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Jan 22 20:17:04 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280969, encodeId=2d5b280969c9, content=很好的文章.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Mon Jan 22 12:08:52 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280752, encodeId=8d5d280e52d7, content=学习了谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Sun Jan 21 19:10:37 CST 2018, time=2018-01-21, status=1, ipAttribution=)]
    2018-01-21 1e145228m78(暂无匿称)

    学习了谢谢作者分享!

    0

相关资讯

病例分享:艾滋病脑炎离我们并不遥远!

艾滋病起源于非洲,后由移民带入美国。1985年,一位到中国旅游的外籍人士患病入住北京协和医院后很快死亡,后被证实死于艾滋病,这是我国第一次发现艾滋病病例。

NAT COMMUN:发现艾滋病毒自我传播的途径

美国芝加哥大学通过计算机建模发现了艾滋病毒迫使细胞将病毒传播给其它细胞过程的细节。这项结果发表在2017年11月7日的《美国国家科学院院刊》上,将为开发抗击艾滋病毒药物提供新的途径。

艾滋病监区警医:用“医心”守望“生命荒原”

“在艾滋病监区做医疗干警,不仅要有‘医身’还要有‘医心’。”49岁的郑张卫进入兰州新桥监狱三监区从事艾滋病病犯监管和治疗已经第13年。他常说,把别人不愿做、不敢做的事做好了,就是一种价值。

乌克兰冲突加剧艾滋病传播

据新华社电 研究人员1月15日说,乌克兰东部自2014年以来发生的武装冲突不仅导致上百万人逃离家园,还加剧了这个国家的艾滋病病毒的传播。新一期美国《国家科学院学报》刊登英国牛津大学等机构研究人员的论文说,他们对2012年到2015年在乌克兰24个诊所收集到的427名病人的艾滋病病毒基因序列进行了分析,得出了病毒迁徙模式。结果显示,冲突导致的人员大规模流动与艾滋病病毒传播紧密相关。据介绍,

PNAS:新的化合物,能够抑制HIV,保护免疫细胞

耶鲁大学的研究人员测试了一种新的化合物,能够抑制HIV,保护免疫细胞,并在一个星期内保持有效。研究人员说,在动物实验中,这种化合物被证明是一种很有希望的新型候选药物,可以增强目前的HIV治疗方案,而不会增加毒副作用。

男子称因患艾滋遭拒诊 医院:未设院感科怕消毒疏漏

“单凭手术室消毒设备不达标而拒绝为我手术,真的有这方面的规定吗?我实在是不能理解。”近日,艾滋病感染者小易(化名)向海口市政府12345热线反映称,自己的就医之路十分波折,希望相关部门可以给和他一样的艾滋病感染者提供一些帮助。据了解,从1999年首次出台医疗机构不得拒绝为艾滋病人进行治疗的规定,到2006年的《艾滋病防治条例》,再到2013年首诊负责制,我国多部法律法规明确不允许推诿拒诊与歧视

Baidu
map
Baidu
map
Baidu
map