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中国皮肤孢子丝菌病确诊患者的临床分析

Clinical Analysis of Patients Diagnosed with Cutaneous Sporotrichosis in China.

作者信息

Zheng Yunyan, Shi Weiwei, Wang Huiying, Zhang Ruzhi

机构信息

Department of Dermatology, The Third Affiliated Hospital of Soochow University, Changzhou, People's Republic of China.

Department of Dermatology, Affiliated Hospital 2 of Nantong University, Nantong, People's Republic of China.

出版信息

Infect Drug Resist. 2024 Jul 31;17:3265-3272. doi: 10.2147/IDR.S471280. eCollection 2024.

Abstract

PURPOSE

This study aimed to improve the understanding of sporotrichosis by analyzing the epidemiological characteristics, clinical manifestations, mycological features, and pathological characteristics of the disease in eastern China.

METHODS

Clinical data of 49 patients diagnosed with cutaneous sporotrichosis in dermatology clinics over a 20-year period were collected and analyzed retrospectively. The analysis included patient demographics, occupations, clinical types, lesion sites, misdiagnosis rates, laboratory investigations, treatment and outcomes.

RESULTS

The study included 22 male and 27 female patients, with a mean age of 52.4 years. Farmers (42.86%) and manual workers (28.57%) had a higher risk of infection. The most common clinical types were lymphocutaneous (30.61%) and fixed (69.39%), predominantly affecting the face and upper limbs. Misdiagnosis as other infectious skin diseases occurred in 35 patients (71.43%). Fungal culture and histopathological examination were important diagnostic tools. Treatment with oral itraconazole for three months led to relief and regression of the skin lesions in most patients, although a few experienced recurrences.

CONCLUSION

Cutaneous sporotrichosis mainly affects individuals working in agriculture and manual labour, with lymphocutaneous and fixed types being the predominant clinical manifestations. The high misdiagnosis rate emphasizes the importance of early recognition, accurate diagnosis and standardized treatment for the prognosis and cure of sporotrichosis. Fungal culture and histopathological examination are essential for diagnosis, and oral itraconazole is an effective treatment option.

摘要

目的

本研究旨在通过分析中国东部地区孢子丝菌病的流行病学特征、临床表现、真菌学特征及病理特征,提高对该疾病的认识。

方法

回顾性收集并分析20年间皮肤科门诊确诊的49例皮肤孢子丝菌病患者的临床资料。分析内容包括患者的人口统计学信息、职业、临床类型、皮损部位、误诊率、实验室检查、治疗及转归。

结果

本研究纳入22例男性和27例女性患者,平均年龄52.4岁。农民(42.86%)和体力劳动者(28.57%)感染风险较高。最常见的临床类型为淋巴管型(30.61%)和固定型(69.39%),主要累及面部和上肢。35例患者(71.43%)被误诊为其他感染性皮肤病。真菌培养和组织病理学检查是重要的诊断工具。多数患者口服伊曲康唑三个月后皮损缓解消退,尽管少数患者有复发。

结论

皮肤孢子丝菌病主要影响从事农业和体力劳动的人群,淋巴管型和固定型为主要临床表现。高误诊率凸显了早期识别、准确诊断及规范治疗对孢子丝菌病预后和治愈的重要性。真菌培养和组织病理学检查对诊断至关重要,口服伊曲康唑是有效的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef1c/11298184/6c8de1d63251/IDR-17-3265-g0001.jpg

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