尖锐湿疣80例误诊分析  

80 cases misdiagnosis of condyloma acuminatum(CA)

作　　者：付小京[1] 唐显华[1] 徐霞[1] 张志海[1] 

机构地区：[1]南方医科大学附属何贤纪念医院皮肤科,511400

出　　处：《中国实用医药》2013年第11期34-35,共2页China Practical Medicine

摘　　要：目的探讨尖锐湿疣(CA)与外阴、阴道内壁、肛周有增生物的其他常见皮肤疾病的鉴别以及误诊原因。方法回顾性分析我院2006年9月至2011年9月间有80例误诊为CA。男32例,女48例,年龄16～70岁,平均28.5岁。皮损分布:包皮5例、龟头后缘近冠状沟处20例、大阴唇12例、小阴唇(内、外)13例、阴道前庭8例、阴阜5例、阴道内壁5例、肛周12例。病例情况:外阴及肛周有增生物73例、有白带异常6例(阴道检查中发现可疑增生物)、有不洁性交史55例。误诊情况:外阴皮内痣3例(3.75%);阴道正常皱壁5例(6.25%);鲍温样丘疹病5例(6.25%);传染性软疣7例(8.75%);扁平湿疣9例(11.25%);皮赘10例(12.50%);外阴假性湿疣20例(25.00%);阴茎珍珠状丘疹21例(26.25%)。结果 80例中有49例无需治疗,31例按相应病因治疗全部好转或治愈。结论尖锐湿疣的诊断应慎重对待,勿草率诊断,加强皮肤性病专业知识的培训,学习掌握尖锐湿疣的鉴别诊断,提高诊疗水平。Objective To research misdiagnosis and identifications of eondyloma acuminatum （CA） and other analogic skin diseases in the eunnus, erissum and vagina wall. Methods 80 cases were misdiagnosed as CA in a retrospective analysis of our hospital from September 2006 to September 2011. These patients contain 32 males and 48 females, in which the youngest was 16 years old and the oldest was 70 years with the average age of 28. 5 years old. Lesions distribution ： the locations of lesions coelude lesions of foreskin with five eases, the glans edge nearly the coronary suleus with 20 eases, the labia majora with 12 eases, lesions in labia minora （inner, outer） with 13 eases, vaginal vestibule with eight eases, the mons pubis with five cases, the vaginal wall with five cases, and perianal with five eases. Cases： 73 cases have puffiness in the vulva and anal, six eases have leucorrhoea anomaly （vaginal examination found suspicious increase biological） , and 55 eases have unclean sexual intercourse history. Misdiagnosis：3 cases （3.75%） with misdiagnosis of genital intraderreal nevi, five eases （6. 25% ） with the normal vaginal folds, five cases （6. 25% ） with Bowen papulosis, 7 （8.75%） cases with the molluseum eontagiosum, 9 cases （11.25%） with fiat eondyloma, 10 eases （12. 50% ） with the skin tag, 20 eases （25.00%） with the vulva in pseudocondyloma, and 21 eases （26. 25% ） with penile pearly papules. Results In all of 80 cases, 49 eases didn＇t need treatment and 31 cases were all cured or improved after proper treatment according to their causes. Conclusion Be discreet to diagnose CA and do not give a conclusion easily. Strengthen the doctors＇ training of specialty knowledge, learn and master differential diagnosis and enhance the level of diagnosis.

关 键 词：尖锐湿疣 诊断 误诊 

分 类 号：R752.53[医药卫生—皮肤病学与性病学]