摘要
目的 分析婴儿红斑鳞屑性皮损处真菌菌丝阳性情况及相关影响因素,为临床诊疗提供依据。方法 2019年4月-2020年3月采集马鞍山市妇幼保健院皮肤科门诊0~12月龄患儿红斑鳞屑性皮损处皮屑,进行荧光染剂Calcofluor White(CFW)荧光染色,高倍镜视野中发现菌丝或假菌丝,判定为阳性。采用卡方检验比较组间菌丝阳性率的差异,多因素分析采用Logistic回归分析。结果 共纳入1 579例患儿为研究对象,红斑鳞屑性皮损菌丝阳性86例,阳性率为5.45%。取材部位在颜面部(OR=0.056,95%CI:0.032~0.098)、头皮(OR=0.043,95%CI:0.010~0.183)、颈部(OR=0.128,95%CI:0.053~0.306)、躯干四肢(OR=0.046,95%CI:0.021~0.099)的菌丝阳性率低于尿布区;取材时间1~3月份(OR=0.310,95%CI:0.142~0.680)、4~6月份(OR=0.240,95%CI:0.114~0.506)、10~12月份(OR=0.471,95%CI:0.263~0.841)的阳性率低于7~9月份。分层分析发现尿布区皮损的菌丝阳性率与月龄和取材时间有关,颜面部皮损的菌丝阳性率与取材时间有关。结论 婴儿红斑鳞屑皮损处存在真菌感染可能,夏季、尿布区是真菌感染的高危因素,夏季颜面部皮损处菌丝阳性率也较高,临床医生需引起重视,针对重点人群积极采取检查措施,避免误诊。
Objective To analyze the positive status of hyphae/pseudohyphae and relevant influencing factors in infantile erythematous scaly lesions and to provide basis for clinical diagnosis and treatment.Methods From April 2019 to March 2020, scales of erythematous scaly lesions was collected from infantile aged 0-12 months in the Dermatology Department of Maanshan Maternal and Child Health Care Hospital, then were subjected to CFW(Calcofluor White) fluorescent staining. Microscopic examination revealed positive hyphae/pseudohyphae. The chi-square test was applied to compare the differences in the hyphae/pseudohyphae positive rate between the groups, and the multivariate analysis was performed using Logistic regression analysis.Results A total of 1 579 infants were enrolled in this research, of whom 86 were hyphae/pseudohyphae positive for erythematous scaly lesions, and the positive rate was 5.45%. The sampling sites included the face(OR=0.056, 95%CI:0.032~0.098), scalp(OR=0.043, 95%CI:0.010~0.183), neck(OR=0.128, 95%CI:0.053~0.306), and the trunk and limbs(OR=0.046, 95%CI:0.021~0.099), with the positive rate lower than that in the diaper area;the sampling time ranged from January to March(OR=0.310, 95%CI:0.142~0.680), from April to June(OR=0.240, 95%CI:0.114~0.506), and from October to December(OR=0.471, 95%CI:0.263~0.841), with the positive rate lower than that from July to September. The stratified analysis results revealed that the hyphae/pseudohyphae positive rate of diaper area was related to the month age and the sampling time, and the hyphae/pseudohyphae positive rate of the facial lesional skin was associated with the sampling time.Conclusion The erythematous scaly lesions of infants might be infected by fungus. Summer time and the lesional skin of diaper area were recognized as high-risk factors for fungal infection. In summer, the hyphae/pseudohyphae positive rate of facial lesional skin was also high. Clinicians should pay attention and take active measures in inspections for key groups to avoid misdiagnosis.
作者
徐建荣
秦红
张凡
李倩云
李剑
XU Jianrong;QIN Hong;ZHANG Fan;LI Qianyun;LI Jian(Department of Dermatology,Maanshan Maternal and Child Health Care Hospital,Ma′anshan 243000,China;Department of Pathology,Ma′anshan Maternal and Child Health Care Hospital,Maanshan 243000,China)
出处
《中国皮肤性病学杂志》
CAS
CSCD
北大核心
2022年第11期1276-1282,共7页
The Chinese Journal of Dermatovenereology
关键词
婴儿
红斑
鳞屑
真菌
菌丝
Infant
Erythema
Scaly lesions
Fungus
Hyphae
