Shepard Zachary, Rios Margarita, Solis Jamie, Wand Taylor, Henao-Martínez Andrés F, Franco-Paredes Carlos, Suarez José Antonio
Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Colorado Denver, Anschutz Medical Campus, 12700 East 19th Avenue, 11C01, Aurora, CO 80045, USA.
Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Panamá.
Curr Trop Med Rep. 2021 Jun;8(2):104-111. doi: 10.1007/s40475-021-00231-8. Epub 2021 Feb 16.
Travel medicine practitioners often are confronted with returning travelers with dermatologic disorders that could be of infectious causes or inflammatory or allergic. Some dermatologic processes are the result of exposure to insects or acquired due to environmental exposures. There is a broad range of dermatosis of infectious and non-infectious etiologies that clinicians need to consider in the differential diagnosis of dermatosis in travelers.
With increasing international travel to tropical destinations, many individuals may be exposed to rickettsia (i.e., African tick bite fever, scrub typhus, or Mediterranean spotted fever), parasitic infections (i.e., cutaneous larva migrans, cutaneous leishmaniasis, African trypanosomiasis, or American trypanosomiasis), viral infections (i.e., measles or Zika virus infection), bacterial (i.e., Buruli ulcer) or ectoparasites (scabies or tungiasis), and myiasis. Cutaneous lesions provide clinical clues to the diagnosis of specific exposures during travel among returned travelers.
Dermatologic disorders represent the third most common health problem in returned travelers, after gastrointestinal and respiratory illness. Many of these conditions may pose a risk of severe complications if there is any delay in diagnosis. Therefore, clinicians caring for travelers need to become familiar with the most frequent infectious and non-infectious skin disorders in travelers.
旅行医学从业者常常会遇到返程旅行者患有皮肤病,这些皮肤病可能由感染、炎症或过敏引起。一些皮肤病变是接触昆虫所致,或因环境暴露而产生。临床医生在对旅行者的皮肤病进行鉴别诊断时,需要考虑多种具有感染性和非感染性病因的皮肤病。
随着前往热带地区国际旅行人数的增加,许多人可能会接触到立克次体(如非洲蜱咬热、恙虫病或地中海斑疹热)、寄生虫感染(如皮肤幼虫移行症、皮肤利什曼病、非洲锥虫病或美洲锥虫病)、病毒感染(如麻疹或寨卡病毒感染)、细菌感染(如布鲁里溃疡)或外寄生虫感染(疥疮或潜蚤病)以及蝇蛆病。皮肤病变为返程旅行者旅行期间特定接触史的诊断提供了临床线索。
皮肤病是返程旅行者中第三大常见健康问题,仅次于胃肠道和呼吸道疾病。如果诊断出现延误,其中许多病症可能会引发严重并发症的风险。因此,负责诊治旅行者的临床医生需要熟悉旅行者中最常见的感染性和非感染性皮肤疾病。