Clinical and social portrait of a patient with HIV-associated psoriasis: case from practice

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Abstract

The tasks of the state strategy of counteraction to the spread of HIV infection in the Russian Federation for the period until 2030 are the development and implementation of individual approaches and targeted programs of HIV prevention in each region, raising the awareness of specialized specialists, especially primary health care doctors, on HIV prevention and diagnosis in order to detect persons with HIV infection at the early stages of the disease. The 2022 standard of primary health care for adults with HIV infection (diagnosis, treatment and follow-up) clearly defines a wide range of specialists involved in the diagnosis of the disease.

The multiplicity of HIV-associated dermatoses explains the role of dermatovenerologists in the diagnostic algorithm. This article describes clinical cases of HIV-associated psoriasis. The attention of specialists is focused on the peculiarities of the clinical picture and course of psoriasis de novo on the background of HIV-infection. The influence of social factors on comorbidity formation was demonstrated. The article mentions the importance of thorough history taking, complex assessment of clinical and social status and psychological characteristics of a patient, development of clear individual diagnostic search upon establishment of final clinical diagnosis. This example points to the need to develop new interdisciplinary algorithms of medical care.

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About the authors

M. M. Tlish

Kuban State Medical University, Ministry of Health of Russia

Author for correspondence.
Email: taya1504@mail.ru
ORCID iD: 0000-0001-9323-4604

Doctor of Medical Sciences, Professor

Russian Federation, Krasnodar

T. G. Kuznetsova

Kuban State Medical University, Ministry of Health of Russia

Email: taya1504@mail.ru
ORCID iD: 0000-0002-0426-5167

Candidate of Medical Sciences, Associate Professor

Russian Federation, Krasnodar

Zh. Yu. Naatyzh

Kuban State Medical University, Ministry of Health of Russia

Email: taya1504@mail.ru
ORCID iD: 0000-0001-9754-5063

Candidate of Medical Sciences, Associate Professor

Russian Federation, Krasnodar

E. V. Erokhina

Clinical Skin and Venereological Dispensary, Ministry of Health of the Krasnodar Territory

Email: taya1504@mail.ru
ORCID iD: 0000-0002-7873-7462

Candidate of Medical Sciences

Russian Federation, Krasnodar

A. I. Perederiy

Clinical Skin and Venereological Dispensary, Ministry of Health of the Krasnodar Territory

Email: taya1504@mail.ru
ORCID iD: 0000-0002-3129-0800
Russian Federation, Krasnodar

References

  1. Правительства Российской Федерации, Распоряжение от 21.12.20 №3468-р «Об утверждении Государственной стратегии противодействия распространению ВИЧ-инфекции в Российской Федерации на период до 2030 года». КонсультантПлюс: справочная правовая система. М., 2020 [The Government of the Russian Federation, Decree No. 3468-r of December 21, 2020 "On approval of the State Strategy for Countering the spread of HIV infection in the Russian Federation for the period up to 2030". ConsultantPlus: Legal reference system. Moscow, 2020 (in Russ.)].
  2. Администрация (губернатора) Краснодарского края, Распоряжение от 19.01.22 №15-р «Об утверждении региональной программы Краснодарского края «Противодействие распространению ВИЧ-инфекции на период до 2030 года». Гарант.ру: справочная правовая система. М., 2022 [Administration (Governor) of the Krasnodar Territory, Order No.15-r dated January 19, 2022 "On approval of the regional program of the Krasnodar Territory "Countering the spread of HIV infection for the period up to 2030». The guarantor.ru: legal reference system. Moscow, 2022 (in Russ.)].
  3. Министерство здравоохранения Российской Федерации, Приказ от 23.06.22 №438н «Об утверждении стандарта первичной медико-санитарной помощи взрослым при ВИЧ-инфекции (диагностика, лечение и диспансерное наблюдение)» (Зарегистрировано в Минюсте России 26.07.22 №69394). КонсультантПлюс: справочная правовая система. М., 2022 [Ministry of Health of the Russian Federation, Order of 23.06.2022 N 438n "On approval of the standard of primary health care for adults with HIV infection (diagnosis, treatment and dispensary monitoring)" (Registered with the Russian Ministry of Justice on 26.07.22, No. 69394). KonsultantPlus: legal reference system. Moscow, 2022 (in Russ.)].
  4. Karadag A.S., Elmas Ö.F., Altunay I.K. Cutaneous manifestations associated with HIV infections: A great imitator. Clinics in dermatology (Hakemli Dergi). 2020; 38 (2): 160–75. doi: 10.1016/j.clindermatol.2019.10.001
  5. Тлиш М.М., Наатыж Ж.Ю., Кузнецова Т.Г. Коморбидность как междисциплинарная проблема: возможности прогнозирования. Лечащий врач. 2020; 10: 55–8 [Tlish M.M., Naatyzh Z.Yu., Kuznetsova T.G. Comorbidity as an interdisciplinary problem: prediction capability. Lechaschi Vrach. 2020; 10: 55–8 (in Russ.)]. doi: 10.26295/OS.2020.52.84.012
  6. Тлиш М.М., Наатыж Ж.Ю., Кузнецова Т.Г. и др. Особенности дерматологической патологии на фоне ВИЧ-инфекции. Тер арх. 2019; 91 (11): 55–9 [Tlish M.M., Naatyzh Zh.Yu., Kuznetsova T.G. et al. Features of dermatological pathology on the background of HIV-infection. Therapeutic Archive. 2019; 91 (11): 55–9 (in Russ.)]. doi: 10.26442/00403660.2019.11.000172
  7. Li Y.-Y., Dong R.-J., Cao L.-J. et al. Case of coincident severe acne and psoriasis in AIDS patient successfully treated with antiretroviral therapy. J Dermatol. 2019; 46 (5): 431–5. doi: 10.1111/1346-8138.14823.
  8. Тлиш М.М., Кузнецова Т.Г., Наатыж Ж.Ю. и др. Полиморбидность: взгляд на сочетанную патологию. Кубанский научный медицинский вестник. 2019; 26 (5): 125–34 [: Tlish M.M., Kuznetsova T.G., Naatyzh Zh.Yu. et al. Polymorbidity: a View on Combined Pathology. Kubanskii Nauchnyi Meditsinskii Vestnik. 2019; 26 (5): 125–34 (in Russ.)]. doi: 10.25207/1608-6228-2019-26-5-125-134

Supplementary files

Supplementary Files
Action
1. JATS XML
2. Patient aged 37 years: а – psoriatic rashes on the skin of the trunk with the greatest concentration in its lower half, on the skin of the shoulders, forearms; б – on the skin of the hips, shins; mostly multiple lenticular and nummular papules; bright pink plaques with the presence of moderate infiltration, which are centrally covered with grayish scales; в – the acral localization of psoriatic rashes on the hand skin; dull yellowish-gray hand nail plates with an uneven bumpy surface, which crumble along the free edge; г – the skin of the toes and sole with a transgredient transition to the back surface of the feet is filled with rich pink plaques with moderate filtration and with layers of crusty scales; there is nail damage

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