Dermatology Unit, I.R.C.C.S. Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Department of Physiopathology and Transplantation, University of Milan, Via Pace, 9, 20122, Milan, Italy.
Eur J Clin Microbiol Infect Dis. 2018 Feb;37(2):301-303. doi: 10.1007/s10096-017-3132-3. Epub 2017 Nov 17.
Kaposi 's sarcoma (KS) is a rare multifocal angioproliferative disease associated with human herpes virus 8 (HHV-8) infection, characterized by cutaneous nodules or plaques especially on the lower limbs. Some skin modifications, such as chronic lymphedema, plantar hyperkeratosis and interdigital desquamation, may be associated with consequent impairment of the local immunosurveillance and increased risk of some bacterial or mycotic infections. With the objective of evaluating if bacterial or mycotic infections in KS patients are supported by different microorganisms compared to control patients, we performed an observational retrospective study, comparing positive cultural swabs of interdigital intertrigo of KS patients with positive cultural swabs of interdigital intertrigo of patients admitted to our dermatologic unit during the last 10 years. One hundred KS patients and 84 control patients were admitted to this study. Some of the skin swabs from interdigital spaces were positive for more than one microorganism, and therefore we found 187 microorganisms among the KS group and 182 microorganisms in the control group. The most common microrganisms among KS patients were T. mentagrophytes (16%), S. aureus (14.9%), P. aeruginosa (13.9%), S. marcescens (5,9%), while among non-KS patients were S. aureus (26,9%), C. albicans (22%), S. agalactiae (7.7%) and E. coli (9.9%). These differences are statistically significant (p < 0.01). KS patients may be more affected by toe web intertrigo due to other bacteria and dermatophytes than the general population. During clinical examination, a careful inspection is necessary for an early diagnosis of toe web intertrigo, in order to prevent serious complications, such as cellulitis and sepsis. Consequently, a cultural examination with antibiogram is required to identify the causative agent of intertrigo and guide antimicrobial therapy.
卡波西肉瘤（KS）是一种罕见的多灶性血管增生性疾病，与人类疱疹病毒 8（HHV-8）感染有关，其特征是皮肤结节或斑块，特别是在下肢。一些皮肤改变，如慢性淋巴水肿、足底过度角化和趾间脱皮，可能与局部免疫监视受损和某些细菌或真菌感染风险增加有关。为了评估 KS 患者的细菌或真菌感染是否与对照患者的不同微生物有关，我们进行了一项观察性回顾性研究，比较了 KS 患者趾间间擦疹的阳性培养拭子与过去 10 年期间我院皮肤科住院患者的趾间间擦疹的阳性培养拭子。这项研究共纳入了 100 名 KS 患者和 84 名对照患者。一些来自趾间区域的皮肤拭子为多种微生物阳性，因此我们在 KS 组中发现了 187 种微生物，在对照组中发现了 182 种微生物。KS 患者中最常见的微生物是 T. mentagrophytes（16%）、金黄色葡萄球菌（14.9%）、铜绿假单胞菌（13.9%）、粘质沙雷菌（5.9%），而非 KS 患者中最常见的微生物是金黄色葡萄球菌（26.9%）、白色念珠菌（22%）、无乳链球菌（7.7%）和大肠杆菌（9.9%）。这些差异具有统计学意义（p<0.01）。KS 患者可能比一般人群更容易受到趾间间擦疹的其他细菌和皮肤真菌的影响。在临床检查中，为了早期诊断趾间间擦疹，以预防蜂窝织炎和败血症等严重并发症，需要仔细检查。因此，需要进行培养检查和药敏试验，以确定间擦疹的病原体，并指导抗菌治疗。
