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孢子丝菌病:89 例连续病例的临床病理研究、文献复习及鉴别诊断的新见解。

Sporotrichosis: A Clinicopathologic Study of 89 Consecutive Cases, Literature Review, and New Insights About Their Differential Diagnosis.

机构信息

The Medical School of Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.

Fluminense Federal University, Niterói, Rio de Janeiro, Brazil; and.

出版信息

Am J Dermatopathol. 2020 Oct;42(10):751-755. doi: 10.1097/DAD.0000000000001617.

Abstract

BACKGROUND

Sporotrichosis is the most common and least severe of deep mycoses. This disease has varied clinic presentation as well as several differential diagnosis.

METHODS

A cross-sectional and retrospective, individually based, observational study, based on records from the dermatopathology service of a university hospital in Brazil. A total of 175 patients were identified with clinical suspicion of sporotrichosis, from 2009 to 2017. Statistical analysis using prevalence ratios was conducted to characterize the clinicopathologic and epidemiological aspects.

RESULTS

The disease was suspected in 175 patients given the clinical presentation. Of these, 86 cases (49.14%) were sporotrichosis, 39 (22.29%) chronic granulomatous inflammatory processes of unidentified etiology, and 5 squamous cell carcinomas (2.86%). The majority of cases (52 or 60.46%) occurred in the upper limbs. A total of 40 samples presented a suppurative chronic granulomatous inflammatory process (46.51%). Only 5 samples (12.50%) showed positive staining (periodic-Schiff acid or GROCOTT).

CONCLUSIONS

The sporotrichosis cases underwent both cumulative and linear growth, especially in the group above 60 years. Squamous cell carcinomas appeared several times as a misdiagnosis of sporotrichosis by dermatologists, so it should be considered as an important differential diagnose due to the current context of skin cancers.

摘要

背景

孢子丝菌病是深部真菌病中最常见和最不严重的一种。这种疾病的临床表现多种多样,也有多种鉴别诊断。

方法

这是一项在巴西一所大学医院皮肤科病理服务处进行的基于个体的回顾性、横断面观察性研究。共发现 175 例有孢子丝菌病临床疑似症状的患者,这些患者的就诊时间为 2009 年至 2017 年。采用患病率比进行统计分析,以描述临床病理和流行病学特征。

结果

根据临床表现,怀疑 175 例患者患有该病。其中,86 例(49.14%)为孢子丝菌病,39 例(22.29%)为原因不明的慢性肉芽肿性炎症,5 例为鳞状细胞癌(2.86%)。大多数病例(52 例,60.46%)发生在上肢。共有 40 例出现化脓性慢性肉芽肿性炎症(46.51%)。只有 5 例(12.50%)显示阳性染色(过碘酸-希夫酸或 GROCOTT)。

结论

孢子丝菌病的病例呈累积性和线性增长,尤其是在 60 岁以上的人群中。由于当前皮肤癌的情况,鳞状细胞癌多次被皮肤科医生误诊为孢子丝菌病,因此应将其视为一个重要的鉴别诊断。

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