皮肤镜在头癣诊断和治疗中的应用价值

发布时间：2018-07-06 19:05

本文选题：头癣 + 皮肤镜学　；参考：《川北医学院》2016年硕士论文

【摘要】：目的:观察头癣在治疗前后皮肤镜下征象及其变化,探讨皮肤镜在头癣诊断及治疗中的价值。方法:收集2015年6月至2016年1月到川北医学院附属医院皮肤科初诊的头癣患者,所有病例收集完整的临床资料、采集大体照片和皮肤镜照片,观察头癣患者治疗前后皮损各个部位(中央及边缘)皮肤镜下征象及其变化情况,并对其进行每2周一次的皮肤镜追踪观察,共8周,对所收集的数据进行统计分析。结果:1.头癣患者男女比例约为1.7:1,平均发病年龄为6岁,学龄前期儿童最多,占48.8%。41例头癣患者中,白癣27例(65.9%)、黑点癣5例(12.2%)、脓癣9例(22.0%)、黄癣0例。真菌镜检阳性率为85.4%,真菌培养阳性率为87.8%。2.治疗前头癣患者皮肤镜下征象出现率由高到低依次为断发(97.6%)、黑点征(95.1%)、甘蔗样发(63.4%)、勾状发(51.2%)、Z型发(26.8%)、脓疱(22.0%)、逗号发(14.6%)、螺旋状发(9.8%);对照组皮肤镜下无甘蔗样发、逗号发、螺旋状发及Z型发。3.白癣中查见甘蔗样发、Z型发,黑点癣中查见逗号发、螺旋状发及Z型发,脓癣中查见甘蔗样发、逗号发及Z型发。4.甘蔗样发与菌丝阳性呈正相关关系(r值为0.036,P值0.05);逗号发、螺旋状发与菌丝阳性呈负相关关系(r值分别为-0.518,-0.411,P值0.05);其余各征象与直接镜检结果的相关关系无统计学意义(P值均0.05)。5.头癣治疗后皮肤镜下各征象逐渐减少,所有皮肤镜下征象消失时真菌检查阴性。结论:1.皮肤镜可对头癣进行诊断,头癣在皮肤镜下可查见特征性的甘蔗样发、逗号发、螺旋状发及Z型发。其中白癣可见甘蔗样发和Z型发,黑点癣可见逗号发、螺旋状发及Z型发,脓癣可见甘蔗样发、逗号发及Z型发。2.皮肤镜指导真菌镜检标本取材,有助于提高真菌镜检阳性率。3.皮肤镜可以对头癣患者进行疗效判断,较真菌镜检及培养方便。
[Abstract]:Objective: To observe the signs and changes of tinea capitis under the skin mirror before and after treatment, to explore the value of skin mirror in the diagnosis and treatment of tinea capitis. Methods: to collect tinea capitis patients in Department of Dermatology of Affiliated Hospital of Chuanbei Medical College from June 2015 to January 2016. The symptoms and changes of skin lesions under the skin lesions (central and edge) of the tinea capitis patients before and after treatment were observed and observed every 2 weeks. The data were analyzed for 8 weeks. The results showed that the proportion of men and women in 1. tinea patients was about 1.7:1, the average age was 6 years old, the most of the preschool children, accounting for 48.. Among 8%.41 cases, there were 27 cases of tinea capitis (65.9%), 5 cases of tinea ringworm (12.2%), 9 cases of psoriasis (22%) and 0 cases of tinea Macris. The positive rate of fungal microscopy was 85.4%. The positive rate of fungal culture was 87.8%.2. in the patients with tinea capitis from high to low (97.6%), black spot sign (95.1%), sugar cane like hair (63.4%), hook hair (51.2%), Z type hair. (26.8%) pustules (22%), comma hair (14.6%), spiral hair (9.8%); in the control group, no sugarcane like hair, comma hair, spiral hair, and Z type.3. tinea ringworm were found in the control group. The hair of sugarcane like hair, Z type hair, spiral hair and Z type hair were found in the black spot ringworm, and the tinea pedis and Z type.4. cane like hair and mycelium were found in the ringworm of the pus. Positive correlation (r value was 0.036, P value 0.05); comma hair, spiral hair and mycelium positive correlation (r value was -0.518, -0.411, P value 0.05 respectively); the correlation between the other signs and direct microscopic examination results was not statistically significant (P value was 0.05), each of the skin microscopic signs gradually decreased after the treatment of.5. tinea capitis, and all the skin microscopic signs disappeared. The fungal examination was negative. Conclusion: 1. skin mirrors can be used to diagnose tinea capitis. The tinea capitis can be found with characteristic sugarcane like hair, comma hair, spiral hair and Z type hair under the skin mirror. The tinea capitis can be seen from the sugarcane like hair and Z type hair, the black spot ringworm can be seen comma hair, spiral hair and Z type hair, the tinea pedis is visible, comma hair and Z type.2. skin mirror finger. The specimen obtained from microscopic examination of fungi helps to improve the positive rate of fungal microscopy..3. skin mirror can be used for the treatment of tinea pedis, and is more convenient than fungal microscopy and culture.
【学位授予单位】：川北医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R756.1

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