儿童头癣66例皮肤镜特征与临床类型及致病菌相关性分析  

Correlation of Dermatoscopic Features with Clinical Types and Pathogenic Bacteria in 66Patients with Tinea Capitis

作　　者：陈瑶[1] 姜倩[1] 董碧麟[1] CHEN Yao;JIANG Qian;DONG Bilin(Department of Dermatology,No.1 Hospital of Wuhan,Wuhan 430022,China)

机构地区：[1]武汉市第一医院皮肤科,湖北武汉430022

出　　处：《中国皮肤性病学杂志》2021年第9期995-1000,共6页The Chinese Journal of Dermatovenereology

基　　金：国家自然科学基金(81301376);湖北省-武汉市卫生健康委联合基金重大项目(WJ2019H311;WX19M01)。

摘　　要：目的探讨儿童头癣的特异性皮肤镜征象与其临床类型、真菌镜检和真菌培养的相关性。方法收集武汉市第一医院皮肤科2019年1月-2020年10月初诊的儿童头癣患者66例,分别对其进行真菌镜检、真菌培养和皮肤镜检查,将观察到的皮肤镜征象与其临床分型、镜下特征和培养菌种进行比较分析。结果最常见的临床类型为黑点癣(43.94%),其次为白癣(30.30%),其主要致病菌分别为紫色毛癣菌和犬小孢子菌。皮肤镜征象发生率最高的为断发(89.39%)和黑点征(75.76%);逗号状发(96.55%)和螺旋状发(82.76%)发生率在黑点癣中较白癣和脓癣高(P<0.001),毛周管鞘(90.00%)、条码样发(80.00%)和Z型发(75.00%)发生率在白癣中比黑点癣和脓癣高(P<0.001),差异均有统计学意义;尽管脓癣皮肤镜下可兼有黑点癣和白癣特征,但不同来源皮肤癣菌所致脓癣的皮肤镜征象存在一定差异。结论皮肤镜镜下征象对儿童头癣的临床类型和病原菌来源分析有一定的提示性作用。Objective To investigate the correlation of specific dermatoscopic signs of tinea capitis in children with their clinical types,fungal microscopy and fungal culture,and to explore the application value of dermatoscope in the diagnosis of tinea capitis in children.Methods A total of 66 children with tinea capitis diagnosed in the Department of Dermatology,No.1 Hospital of Wuhan from January 2019 to October 2020 were enrolled for fungal microscopy,fungal culture,and dermoscopy.The dermatoscopic signs observed were compared with their clinical type,microscopic characteristics and cultured strains.Results The most common clinical type was black dot tinea(43.94%),followed by microsporosis capitis(30.30%).The major etiological agents were Trichophyton violaceum and Microsporum canis respectively. The most frequent dermatoscopic signs were broken hair(89.39%)and black dot tinea(75.76%).There was significant higher prevalence of comma-like hair(96.55%)and spiral-like hair(82.76%)in black dot tinea than in microsporosis capitis and tinea kerion(P<0.001).On the other hand,there was significant higher prevalence of pheripheral sheaths(90.00%),barcode-like hair(80.00%)and Z-shaped hair(75.00%)in microsporosis capitis than in black dot tinea and tinea kerion(P<0.001).Although some common features of black dot tinea and tinea kerion could be observed,there existed some distinctive characteristics in kerions caused by the agents with different sources.Conclusion Dermoscopic signs have a certain suggestive effect on the clinical types of tinea capitis in children and the source of pathogenic bacteria.

关 键 词：儿童头癣 皮肤镜 逗号状发 螺旋状发 条码样发 Z型发 

分 类 号：R756.1[医药卫生—皮肤病学与性病学]