合并症作为急性和复发性丹毒的危险因素
Comorbidities as Risk Factors for Acute and Recurrent Erysipelas.
作者信息
Brishkoska-Boshkovski Vesna, Kondova-Topuzovska Irena, Damevska Katerina, Petrov Andrej
机构信息
Department of Dermatology, City General Hospital 8th September, Skopje, Republic of Macedonia.
University Infectious Diseases Clinic, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje Republic of Macedonia.
出版信息
Open Access Maced J Med Sci. 2019 Mar 15;7(6):937-942. doi: 10.3889/oamjms.2019.214. eCollection 2019 Mar 30.
BACKGROUND
Erysipelas is a common infectious skin disease. A typical feature of erysipelas, especially on the lower limbs, is the tendency to reoccur and the study aimed to define the comorbidities associated with it.
AIM
We aimed to investigate systemic and local comorbidities in patients diagnosed with erysipelas on the lower limbs.
MATERIAL AND METHODS
We conducted a retrospectively-prospective, population-based cohort study which included all patients diagnosed with erysipelas on the lower limbs, during two years. Patients were divided into two groups: patients with first episode and patients with recurrent erysipelas. These two groups were compared, with particular emphasis on systemic and local comorbidities.
RESULTS
The study included 313 patients, of which 187 with the first episode of erysipelas and 126 with a recurrent. Regarding the analyzed systemic risk factors, the recurrent erysipelas was significantly associated with obesity (p < 0.0001), insulin dependent diabetes mellitus (p = 0.0015), history of malignant disease (p = 0.02) and tonsillectomy (p = 0.000001). For a p-value < 0.0001, significantly more frequent finding of peripheral arterial occlusive disease, chronic oedema/lymphoedema, fungal infections of the affected leg and chronic ulcer was confirmed in recurrent erysipelas. Neuropathy had 23% of the recurrent cases and 8.6% in patients without recurrence, and the difference was found to be significant for p = 0.0003. The only dissection of the lymph nodes was found more frequently in recurrent erysipelas (p = 0.017), but no associations with other analysed local surgery on the affected leg. Patients with recurrent erysipelas had ipsilateral coexisting dermatitis p = 0.00003 significantly more frequent. Minor trauma often preceded the first episode of erysipelas p = 0.005.
CONCLUSION
Identification and treatment of modifiable risk factors are expected to reduce the risk of a subsequent episode of erysipelas on the lower limbs.
背景
丹毒是一种常见的感染性皮肤病。丹毒的一个典型特征，尤其是在下肢，是有复发倾向，本研究旨在确定与之相关的合并症。
目的
我们旨在调查被诊断为下肢丹毒患者的全身和局部合并症。
材料与方法
我们进行了一项回顾性-前瞻性、基于人群的队列研究，纳入了两年内所有被诊断为下肢丹毒的患者。患者分为两组：初发患者和复发性丹毒患者。对这两组进行比较，特别关注全身和局部合并症。
结果
该研究纳入了313例患者，其中187例为丹毒初发患者，126例为复发性患者。关于分析的全身危险因素，复发性丹毒与肥胖（p < 0.0001）、胰岛素依赖型糖尿病（p = 0.0015）、恶性疾病史（p = 0.02）和扁桃体切除术（p = 0.000001）显著相关。对于p值< 0.0001，在复发性丹毒中证实外周动脉闭塞性疾病、慢性水肿/淋巴水肿、患侧腿部真菌感染和慢性溃疡的发现明显更频繁。神经病变在复发性病例中占23%，在无复发患者中占8.6%，发现差异在p = 0.0003时具有统计学意义。仅淋巴结清扫在复发性丹毒中更频繁地出现（p = 0.017），但与患侧腿部其他分析的局部手术无关联。复发性丹毒患者同侧共存性皮炎明显更频繁（p = 0.00003）。轻微创伤常在丹毒初发前出现（p = 0.005）。
结论
识别和治疗可改变的危险因素有望降低下肢丹毒后续发作的风险。
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