A review article is addressed the issue of the diagnosis and treatment of syphilis that is developing against the background of HIV infection. A small number of HIV-infected patients may have false-negative or false-positive serological tests for syphilis. Patients with co-infection are at higher risk of the nervous system involvement as well as ocular and otological syphilis. The cases of treatment failure and neurorelapses are also more frequent in HIV-positive patients with syphilis. The effectiveness of neurosyphilis treatment in co-infected patients is difficult to assess, as the normalization of the CSF in HIV-positives is going slower comparing to HIV-negatives. The inevitable increase in incidence of syphilis and HIV co-infection is anticipated in the coming years. In this regard, a comprehensive study of the co-infection problem and improvement of approaches to managing patients based on the principles of evidence-based medicine is required.
Recently, management of patients co-infected with syphilis and HIV infection is becoming an increasingly important problem. Similarity of circumstances and ways of HIV and syphilis transmission as well as populations at risk of infection suggests that in the coming years the number of cases of co-infection will increase. The .negative synergy. of HIV infection and syphilis has been proven. This means a mutual reinforcement of the negative effect, when each of the diseases in their combination is more unfavorable than the separately existing disease. Syphilis increases the likelihood of HIV acquisition and transmission during unprotected sexual intercourse and contributes to the progression of HIV infection. On the other hand, it is traditionally believed that concomitant HIV infection can significantly change clinical features and course of syphilis and make its diagnosis and treatment more complicated. However, the widespread use of antiretroviral therapy has allowed to significantly reduce this negative effect. The review article is devoted to the problem of the biological and epidemiological .synergy. of these two infections, as well as to the analysis of modern data on the clinical features of syphilis developing against the background of HIV infection.
Описан чрезвычайно редкий случай синусного гистиоцитоза нелангергансового типа у пациентки 55 лет с изолированной локализацией процесса на коже правой щеки, без вовлечения нодулярных структур. Основным кожным проявлением был узел эритематозно-синюшного цвета, с наличием множественных милиумподобных высыпаний на поверхности. При патоморфологическом исследовании особенностью являлось наличие большого количества плазматических клеток, кроме этого описан феномен эмпериполеза, который сначала был ошибочно воспринят морфологами как «фагоцитоз». При иммуногистохимическом исследовании изменения характеризовались пролиферацией крупных полигональных гистиоцитов с накоплением пенталамеллярных маркеров в их цитоплазме (протеин S-100, CD68). Ключевые слова: синусный гистиоцитоз кожи нелангенгарсового типа, кожная форма, эмпериполез, диагностика, иммуногистохимическое (ИГХ) исследование биоптата Конфликт интересов: авторы заявляют об отсутствии потенциального конфликта интересов, требующего раскрытия в данной статье.
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