利用氨苯砜和血红蛋白进行皮肤利什曼病的上皮皮肤再生治疗：病例报告和综合文献复习。
Utilization of dapsone and hemoglobin in the epithelial skin regeneration therapy of cutaneous loxoscelism: A case report and integrative literature review.
机构信息
MD. Physician, Medical staff, emergency department, general hospital de Pachuca. Pachuca, Hidalgo, Mexico; Subject teacher, Academic Field of Medicine, Institute of Health Sciences, Universidad Autónoma del Estado de Hidalgo, Pachuca, Hidalgo, Mexico.
MD, PhD. Professor, Department of Medicine, School of Health Sciences, Universidad Autónoma del Estado de Hidalgo. Pachuca, Hidalgo, Mexico.
出版信息
Sao Paulo Med J. 2024 Feb 23;142(4):e2023151. doi: 10.1590/1516-3180.2023.0151.04012023. eCollection 2024.
BACKGROUND
Loxosceles spp are arthropods found worldwide. Its bite may produce cutaneous loxoscelism (necrotic or edematous) or cutaneous-visceral loxoscelism. Depending on their severity and location, cutaneous forms are managed with local cold application and systemic administration of antihistamines, corticosteroids, antibiotics, polymorphonuclear inhibitors, and analgesics.
OBJECTIVE
This study aimed to report a case of cutaneous loxoscelism and to identify the main dermatological manifestations associated with the Loxosceles spp bite.
DESIGN AND SETTING
This case report and literature review was conducted in a Mexican university.
METHODS
A detailed report on the medical management of a patient with cutaneous loxoscelism treated at the emergency department of a public hospital was published. Scopus, PubMed, Web of Science, and Google Scholar databases were searched to identify articles reporting cutaneous loxoscelism. The following keywords were used during the database search: "loxoscelism" OR "spider bite," OR "loxosceles" OR "loxosceles species" OR "loxosceles venom" OR "loxoscelism case report" AND "cutaneous" OR "dermonecrotic arachnidism."
RESULTS
A 62-year-old female patient with cutaneous loxoscelism was treated with systemic dapsone and local heparin spray. Eighteen studies with 22 clinical cases were included in this systematic review. Of the 22 patients, 12 (54.5%) were men. L. rufescens was the predominant spider species.
CONCLUSIONS
The administration of dapsone and heparin for the management of cutaneous loxoscelism demonstrated success in this case, with no sequelae observed. In general, the literature review indicated favorable outcomes in patients treated with antimicrobials and corticosteroids, with continuous healing of skin lesions.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO ID CRD42023422424 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023422424).
背景
Loxosceles 属节肢动物分布于世界各地。其叮咬可导致皮肤利什曼病（坏死或水肿）或皮肤内脏利什曼病。根据其严重程度和位置，采用局部冷敷和全身给予抗组胺药、皮质类固醇、抗生素、多形核白细胞抑制剂和镇痛药治疗皮肤利什曼病。
目的
本研究旨在报告一例皮肤利什曼病病例，并确定与 Loxosceles spp 叮咬相关的主要皮肤病表现。
设计和设置
本病例报告和文献复习在墨西哥一所大学进行。
方法
发表了一篇关于在公立医院急诊科治疗的皮肤利什曼病患者的医学治疗详细报告。在 Scopus、PubMed、Web of Science 和 Google Scholar 数据库中搜索了报告皮肤利什曼病的文章。在数据库搜索中使用了以下关键词：“利什曼病”或“蜘蛛咬伤”，或“Loxosceles”或“Loxosceles 种”或“Loxosceles 毒液”或“利什曼病病例报告”和“皮肤”或“皮肤坏死性节肢动物病”。
结果
一名 62 岁女性患者患有皮肤利什曼病，接受了全身性氨苯砜和局部肝素喷雾治疗。本系统评价纳入了 18 项研究共 22 例临床病例。22 例患者中，12 例（54.5%）为男性。L. rufescens 是主要的蜘蛛物种。
结论
在本例中，氨苯砜和肝素的给药治疗皮肤利什曼病取得了成功，未观察到后遗症。一般来说，文献复习表明，接受抗生素和皮质类固醇治疗的患者预后良好，皮肤病变持续愈合。
系统评价注册
PROSPERO ID CRD42023422424（https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023422424）。
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