de Andrade M F, Nishinari K, Puech-Leão P
Departamento de Cirurgia da Faculdade de Medicina da Universidade de São Paulo.
Rev Hosp Clin Fac Med Sao Paulo. 1998 Jan-Feb;53(1):3-5.
Cutaneous lesions in the interdigital spaces are commonly seen in lymphedema patients and their prevention and suitable care is one of the cornerstones of any successful treatment, by preventing acute inflammations and additional worsening in limb volume and fibrosis. We obtained swab specimens from the interdigital area from 21 patients followed in the Lymphedema Unit of the Department of Vascular Surgery of the University of São Paulo; thirteen of them had lesions suggestive of tinea pedis. The pathological agent could be identified in 11 out of these 13 patients: fungal infection alone was responsible for seven lesions, Corynebacterium minutissimum for another two and both agents were isolated from two patients. Although two patients had evident clinical lesion of the skin, no fungal or bacterial species could be isolated. From the eight patients without interdigital lesions, Candida and Corynebacterium was found in one. We concluded that clinical examination has a high sensibility (84%) and specificity (91%) but the high prevalence of Corynebacterium minutissimum suggests that adequate treatment should follow careful laboratory examination.
指间间隙的皮肤病变在淋巴水肿患者中很常见，其预防和适当护理是任何成功治疗的基石之一，可预防急性炎症以及肢体体积和纤维化的进一步恶化。我们从圣保罗大学血管外科淋巴水肿科随访的21例患者的指间区域获取了拭子标本；其中13例有足癣的病变提示。这13例患者中有11例可鉴定出病原体：仅真菌感染导致7例病变，微小棒状杆菌导致另外2例，2例患者同时分离出这两种病原体。尽管有2例患者有明显的皮肤临床病变，但未分离出真菌或细菌种类。在8例无指间病变的患者中，1例发现念珠菌和棒状杆菌。我们得出结论，临床检查具有较高的敏感性（84%）和特异性（91%），但微小棒状杆菌的高患病率表明，在仔细的实验室检查后应进行适当治疗。
