通过光学相干断层扫描鉴别葡萄球菌烫伤样皮肤综合征和中毒性表皮坏死松解症的病例报告
A case report of differentiating staphylococcal scalded skin syndrome and toxic epidermal necrolysis by optical coherence tomography.
作者信息
Hussain A A, Banzhaf C A, Themstrup L, Nielsen P L, Jemec G B E
机构信息
Department of Dermatology, Roskilde Hospital, University of Copenhagen, Roskilde, Denmark.
Department of Pathology, Roskilde Hospital, University of Copenhagen, Roskilde, Denmark.
出版信息
Skin Res Technol. 2015 Aug;21(3):363-5. doi: 10.1111/srt.12200. Epub 2015 Jan 12.
BACKGROUND
Staphylococcal scalded skin syndrome (SSSS) and toxic epidermal necrolysis (TEN) both present with acute onset, high morbidity and significant mortality. Rapid diagnosis is therefore of importance. The aim of this study was to investigate and compare the presentation of these diseases using optical coherence tomography (OCT).
METHODS
Two male patients with bullous diseases, SSSS and TEN, respectively, were photographed digitally, examined using dermoscopy, OCT scanned and subsequently biopsied in the said order.
RESULTS
The bullous skin was visualized by OCT showing two distinct images: the SSSS-patient displayed superficial hyporefletive flaccid structures with a split high in the thickened (0.51 mm vs. 0.12 mm) epidermis while the TEN-patient demonstrated a larger hyporeflective ovoid structure with a split right below the thickened epidermis (0.18 mm vs. 0.06 mm).
CONCLUSION
These findings suggest that there is a potential for the application of OCT scanning in the acute phase of SSSS and TEN in order to distinguish them for a faster diagnosis and better management and treatment.
背景
葡萄球菌性烫伤样皮肤综合征（SSSS）和中毒性表皮坏死松解症（TEN）均起病急、发病率高且死亡率显著。因此，快速诊断至关重要。本研究旨在利用光学相干断层扫描（OCT）对这些疾病的表现进行调查和比较。
方法
分别对两名患有大疱性疾病（SSSS和TEN）的男性患者进行数码拍照、皮肤镜检查、OCT扫描，随后按上述顺序进行活检。
结果
OCT显示大疱性皮肤呈现两种不同图像：SSSS患者表现为浅表低反射性松弛结构，在增厚的表皮（0.51毫米对0.12毫米）中上部有分裂；而TEN患者表现为较大的低反射性卵圆形结构，在增厚表皮下方有分裂（0.18毫米对0.06毫米）。
结论
这些发现表明，在SSSS和TEN的急性期应用OCT扫描有潜力区分它们，以便更快诊断并进行更好的管理和治疗。
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