We report the case of a 40-year-old male patient, polytoxicated since adolescence, with a first admission to prison at 20 years, and repeated admissions later.
In 1993, HIV and HCV coinfection was detected.
Its clinical history consists of the prescription of the first mental disorder in 1998, with constant abandonment, especially during periods of freedom.
Other pathologies of interest:
- pneumocystitis jirovecii pneumonia (formerly known as carinii) in 1998
- recurrent community acquired pneumonia
- oropharyngeal and probably esophageal candidiasis,
- pulmonary TB and cerebral lesions due to toxoplasmosis and/or TB
- practically constant seborrheic dermatitis
In August 2009 he presented crusted, scaly, non-pruriginous lesions of scalp onset, auricular pavilions and armpits.
Subsequently, these lesions extended to the trunk and extremities, including soles and palms of feet and hands.
Similar lesions in the interglottic and genital folds also appeared.
The dermatologist advised the patient to present psoriasis, receiving treatment with calcipotriol plus betamethasone, salicylic vaseline and tracolimus 0.1%.
This treatment was not initiated until a new imprisonment in early 2010.
A slight improvement has been seen in recent weeks.
At the beginning of the clinical picture, the CD4+ cell/ml lymphocyte count was 64 with an HIV CV of 1,090,000 copies/ml (6.04 log).
He also had significant cachexia (BMI < 16) and anemia (Hbina of 10 g/dl; Htcto.
The patient refuses to speak.
Currently, in hospital admission to study possible etymology of brain lesions.
