综合性医院皮肤科门诊麻风78例临床与病理分析

发布时间：2018-04-01 04:44

本文选题：麻风　切入点：临床表现　出处：《中国皮肤性病学杂志》2017年05期

【摘要】：目的了解麻风临床表现和组织病理特点,提高皮肤科医师麻风确诊率。方法回顾性分析2008年1月-2016年7月本科门诊经过组织病理检查而确诊的麻风患者的临床特资料。结果共统计麻风78例,临床表现有局限性浸润、弥漫性浸润、环形至不规则形色素减退性斑片、斑块、结节及溃疡,可伴随眉毛脱落、耳神经和/或尺神经粗大、发热;皮损主要位于面颈、躯干、四肢。临床分型:结核样型20.51%(16/78),界限类偏结核样型2.56%(2/78),中间界限类5.13%(4/78),界限类偏瘤型14.10%(11/78),瘤型17.95%(14/78),未定型麻风1.28%(1/78),临床病理未能分型39.74%(31/78)。病理结果:真皮血管、神经、附属器周围见不同程度的炎性细胞或泡沫样组织细胞浸润;病变累及真皮浅中层53.85%(42/78),其中表皮基底层破坏93.59%(73/78),表皮萎缩、变薄55.13%(43/78),有无浸润带者46.15%(36/78)。抗酸染色:组织切片染色阳性率47.44%(37/78);仅15.38%(12/78)完成组织液涂片染色。结论麻风临床表现多样,组织病理具有特异性改变,联合抗酸染色检查,可大大提高麻风的诊断水平,降低漏诊率和误诊率。
[Abstract]:Objective to investigate the clinical and histopathological features of leprosy and to improve the diagnosis rate of leprosy by dermatologists.Methods Clinical data of leprosy patients diagnosed by histopathological examination from January 2008 to July 2016 were analyzed retrospectively.Results 78 cases of leprosy showed localized infiltration, diffuse infiltration, circular to irregular hypochromic patch, plaque, nodules and ulceration, accompanied by exfoliation of eyebrow, extensive auricular nerve and / or ulnar nerve and fever.The lesions are mainly located in the neck, torso, and limbs.Clinical classification: tuberculoid type 20.51% 16 / 78, borderline tuberculoid type 2.56% / 78, middle limit class 5.13% 4 / 78, line type 14.1010% 1178%, tumor type 17.95% 1478%, unshaped leprosy 1.281 / 78%, clinicopathologic type not 39.7474% ~ 3178%.Pathological results: inflammatory cells or foam like cells were infiltrated in various degrees around dermis vessels, nerves and appendages, and the lesions involved 53.85% 42 / 78 of dermis, in which the basal layer of epidermis was destroyed 93.599-73 / 78, epidermis atrophied and thinned 55.1343 / 78C, and there were no infiltrating bands (46.1515 / 3678 / 78).Acid-fast staining: the positive rate of tissue section staining was 47.44% and 37 / 78%; only 15.38% ~ 12 / 78) tissue smear staining was completed.Conclusion the clinical manifestations of leprosy are various and the histopathology has specific changes. Combined with acid-fast staining, the diagnostic level of leprosy can be greatly improved, and the rate of missed diagnosis and misdiagnosis can be reduced.
【作者单位】：昆明医科大学第一附属医院皮肤科;昆明医科大学附属延安医院检验科;
【分类号】：R755

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