Program in Dermatopathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
J Am Acad Dermatol. 2013 Feb;68(2):301-5. doi: 10.1016/j.jaad.2012.07.016. Epub 2012 Aug 30.
Cutaneous gnathostomiasis is an emerging food-borne parasitic zoonosis. Histopathological demonstration of the larva on random biopsy specimen of erythematous plaques is infrequent because of its migrating nature.
We sought to determine whether medical treatment with albendazole or ivermectin increases the diagnostic yield of skin biopsy specimen.
A retrospective chart review was conducted in a private dermatology practice in Lima, Peru. Cases with a clinical diagnosis of nodular migratory panniculitis and pathological diagnosis of eosinophilic panniculitis or gnathostomiasis were reviewed. Only cases with definitive diagnosis confirmed by histopathology or parasite isolation were included in the study.
A definitive diagnosis of gnathostomiasis was rendered in 6 of 55 reviewed cases. Histopathological or gross identification of the nematode's larva was made obtaining a biopsy specimen of papules or pseudofuruncles that developed after oral antiparasitic treatment.
This is a retrospective case series study and no serologic testing was available.
Biopsy of a papule or pseudofuruncle subsequent to oral treatment increases the likelihood of demonstrating the larva on skin biopsy specimen, which allows definitive diagnosis and may have therapeutic benefit.
皮肤颚口线虫病是一种新兴的食源性寄生虫病。由于幼虫的迁移特性，在红斑斑块的随机活检标本中很少能看到幼虫的组织病理学表现。
我们旨在确定阿苯达唑或伊维菌素等药物治疗是否会增加皮肤活检标本的诊断率。
对秘鲁利马的一家私人皮肤科诊所进行了回顾性图表审查。对临床诊断为结节性游走性脂膜炎和病理诊断为嗜酸性脂膜炎或颚口线虫病的病例进行了回顾。只有通过组织病理学或寄生虫分离明确诊断的病例才被纳入研究。
在 55 例回顾性病例中，有 6 例明确诊断为颚口线虫病。在接受口服驱虫治疗后出现丘疹或假性疖的活检标本中，通过组织病理学或肉眼观察到了线虫幼虫。
这是一项回顾性病例系列研究，没有进行血清学检测。
口服治疗后活检丘疹或假性疖可增加皮肤活检标本中幼虫的检出率，从而明确诊断，并可能具有治疗益处。
