15例成人头癣回顾性分析  

Retrospective analysis of 15 cases of tinea capitis in adults

作　　者：谢振谋 郑和平 陈永飞 刘红芳 黄进梅 薛耀华 刁波 XIE Zhenmou;ZHENG Heping;CHEN Yongfei;LIU Hongfang;HUANG Jinmei;XUE Yaohua;DIAO Bo(The First School of Clinical Medicine,Southern Medical University,Guangzhou 510260,China;Basic Medical Laboratory,Ceneral Hospital of Central Theater Command,Wuhan 430070,China;Department of Laborarory,Dermatology Hospital,Southern Medical University,Guangzhou 510091,China;Guangzhou Key Laboratory of Precise Prevention and Control of Sexually Transmitted Diseases,Guangzhou 510091,China;Department of Dermatology,Dermatology Hospital,Southern Medical University,Guangzhou 510091,China;Department of Laborarory,Center Blood Station of Shunde,Foshan 528300,China)

机构地区：[1]南方医科大学第一临床医学院,广州510260 [2]中部战区总医院基础医学实验室,武汉430070 [3]南方医科大学皮肤病医院检验科,广州510091 [4]广州市性传播疾病精准防控重点实验室,广州510091 [5]南方医科大学皮肤病医院皮肤科,广州510091 [6]佛山市顺德区中心血站检验科,佛山528300

出　　处：《中国真菌学杂志》2024年第4期361-366,共6页Chinese Journal of Mycology

基　　金：广州市科技计划项目(202201000007)。

摘　　要：目的了解广州某医院成人头癣流行病学、病原菌和临床特征。方法对2017年1月—2022年12月在南方医科大学皮肤病医院就诊并经临床和真菌培养结果诊断为头癣的患者(年龄≥18岁)的临床资料进行分析。结果15例成人头癣患者中,女性12例(80.0%),男性3例(20.0%),其中9例(60.0%)分布在青年期18~40岁;主要致病菌为紫色毛癣菌7株(46.7%);临床表现主要为瘙痒、红斑、丘疹、鳞屑、脓疱和痛等。13例患者有误诊史,误诊率达到86.7%,易误诊为脂溢性皮炎和细菌性毛囊炎等疾病;患者病程1~240个月,平均病程42.4个月,病程中位数为3个月;7例患者进行皮肤镜检查,其中6例提示头癣或真菌感染。10例患者经系统治疗后痊愈。结论广州某医院成人头癣流行病学、病原菌和临床特征与国内外报道的特点相似,但在感染患者的年龄段上有所差异,病程也更长。临床应提高成人头癣的认识与警惕,同时把真菌学检查和皮肤镜检查作为常规手段,从而提高成人头癣诊断的准确率和避免误诊。Objective To investigate the epidemiology,pathogen and clinical characteristics of adult tinea capitis cases in a hospital in Guangzhou.Methods The clinical data of patients(≥18 years old)who visited the Dermatology Hospital of Southern Medical University from January 2017 to December 2022 and were diagnosed with tinea capitis by clinical and fungal culture results were analyzed.Results Among the 15 tinea capitis patients,12(80.0%)were female,and 3(20.0%)were male,and 9(60.0%)of them were distributed in young adults age range of 18 to 40 years.7 strains of Trichophyton violaceum(46.7%)were the main pathogen,clinical manifestations were mainly characterized by pruritus,erythema,papules,scales,such as pain and pustules;13 patients had a history of misdiagnosis,with a misdiagnosis rate of 86.7%,and were easily misdiagnosed as seborrheic dermatitis,bacterial folliculitis and other diseases.The disease duration ranged from 1 to 240 months,with an average of 42.4 months and a median of 3 months;7 patients underwent dermatoscope,and 6 of them suggested tinea capitis or fungal infection.Ten patients recovered after systematic treatment.Conclusion The epidemiological,pathogenic and clinical characteristics of adult tinea capitis in a hospital in Guangzhou were similar to those reported at home and abroad,but there were differences in the age of infected patients and the course of disease is longer.In order to improve the accuracy of the diagnosis and avoid misdiagnosis,it is necessary to raise the awareness and vigilance of adult tinea capitis and take mycolic examination and dermatoscope as routine means.

关 键 词：成人头癣 紫色毛癣菌 皮肤镜 临床特征 

分 类 号：R756.1[医药卫生—皮肤病学与性病学]