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人皮肤利什曼病:巴西皮肤科学会关于临床、诊断和治疗管理的建议。

Human sporotrichosis: recommendations from the Brazilian Society of Dermatology for the clinical, diagnostic and therapeutic management.

机构信息

Dermatology Department, University of Rio de Janeiro State, Rio de Janeiro, RJ, Brazil; Department of Mycology, Brazilian Society of Dermatology, Rio de Janeiro, RJ, Brazil.

Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil.

出版信息

An Bras Dermatol. 2022 Nov-Dec;97(6):757-777. doi: 10.1016/j.abd.2022.07.001. Epub 2022 Sep 22.

Abstract

BACKGROUND

The increase in the zoonotic epidemic of sporotrichosis caused by Sporothrix brasiliensis, which started in the late 1990s in Rio de Janeiro and is now found in almost all Brazilian states, has been equally advancing in neighboring countries of Brazil. Changes in the clinical-epidemiological profile, advances in the laboratory diagnosis of the disease, and therapeutic difficulties have been observed throughout these almost 25 years of the epidemic, although there is no national consensus. The last international guideline dates from 2007.

OBJECTIVES

Update the clinical classification, diagnostic methods and recommendations on the therapeutic management of patients with sporotrichosis.

METHODS

Twelve experts in human sporotrichosis were selected from different Brazilian regions, and divided into three work groups: clinical, diagnosis and treatment. The bibliographic research was carried out on the EBSCOHost platform. Meetings took place via electronic mail and remote/face-to-face and hybrid settings, resulting in a questionnaire which pointed out 13 divergences, resolved based on the opinion of the majority of the participants.

RESULTS

The clinical classification and laboratory diagnosis were updated. Therapeutic recommendations were made for the different clinical forms.

CONCLUSION

Publication of the first national recommendation, carried out by the Brazilian Society of Dermatology, aimed at the Brazilian scientific community, especially dermatologists, infectologists, pediatricians, family medicine personnel, and laboratory professionals who work in the management of human sporotrichosis.

摘要

背景

由巴西枝孢霉引起的孢子丝菌病的人畜共患病疫情自 20 世纪 90 年代末在里约热内卢开始,并已在巴西几乎所有州发现,目前在巴西的邻国也同样在蔓延。近 25 年来,人们观察到了临床-流行病学特征的变化、疾病实验室诊断的进步以及治疗的困难,尽管没有国家共识。最后一次国际指南是在 2007 年发布的。

目的

更新孢子丝菌病的临床分类、诊断方法和治疗管理建议。

方法

从巴西不同地区选择了 12 名人类孢子丝菌病专家,并将其分为三个工作组:临床、诊断和治疗。文献研究在 EBSCOHost 平台上进行。会议通过电子邮件、远程/面对面和混合方式进行,产生了一个调查问卷,其中指出了 13 个分歧点,根据大多数参与者的意见解决了这些分歧。

结果

更新了临床分类和实验室诊断。对不同的临床形式提出了治疗建议。

结论

巴西皮肤病学会发布了第一份国家建议,旨在为巴西科学界,特别是皮肤科医生、传染病专家、儿科医生、家庭医学人员以及从事人类孢子丝菌病管理的实验室专业人员提供建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5989/9582924/fc27eeb23ced/gr1.jpg

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