Reticuloide actínico como manifestación inicial de un paciente con infección por VIH.

BACKGROUND: Actinic reticuloid is a chronic photodermatosis characterized by erythematous-edematous papules and plaques that evolve into residual pigmented macules, initially located in photoexposed areas and related to daylight exposure. CLINICAL CASE: A 70-year-old male patient, originally from Tampico, Tamaulipas, and resident of Ciudad Madero, Tamaulipas, Mexico, with erythematosquamous, pruritic plaques affecting 90% of the body surface of 8 months of evolution. During his diagnostic approach, it was taken a first biopsy of the lesions, with data compatible with the diagnosis of actinic reticuloid: spongiotic hyperplasia of the epidermis with superficial perivascular lymphocytic infiltrate and lichenoid appearance. Subsequently, a second biopsy was taken confirming the diagnosis of actinic reticuloid. Complementary studies found HIV positive serology, as well as antibodies against Treponema pallidum. Antiretroviral therapy was administered with tenofovir, emtricitabine and efavirenz 300/200/600 mg in tablets 1 every 24 hours; doxycycline 100 mg orally every 12 hours for 14 days and thalidomide 100 mg every 24 hours. After 2 months of treatment the patient showed clinical and biochemical relieve of the lesions, decrease of pruritus, improvement in lymphocyte count and decrease of viral load for HIV. CONCLUSIONS: This case represents a clinical and histopathological description of actinic reticuloid in a patient with HIV and primary syphilis. [ABSTRACT FROM AUTHOR]