摘要
目的了解儿童脓癣的致病菌、临床类型以及治疗方法。方法回顾性分析2011年4月-2021年8月北京儿童医院皮肤科脓癣患儿的致病菌、临床特点、治疗方案及预后情况。结果148例脓癣患者中表现为单个痈样脓肿型38例,多个小脓肿融合成大片型38例,毛囊性脓疱性红斑块型41例,毛囊炎样损害型31例。4种脓癣临床类型中犬小孢子菌均为主要致病菌,其中在毛囊炎样损害型和毛囊性脓疱性红斑块型脓癣中犬小孢子菌占比最高,分别为70.97%和56.10%。须癣毛癣菌复合体则更易形成单个痈样脓肿型(26.32%)。所有脓癣患者均采用口服特比萘芬抗真菌治疗,同时联合抗炎治疗。根据脓癣不同临床类型,抗炎治疗方案分别为应用糖皮质激素(口服或者外用)或者口服复方甘草酸苷治疗,所有患儿治疗8周后有效率为97.97%。结论儿童脓癣的致病菌以犬小孢子菌为主,但须癣毛癣菌复合体引起的脓癣炎症反应常更强烈。临床抗真菌治疗的同时,联合抗炎治疗可获得较好的疗效。应根据脓癣的不同类型,制定相应的抗炎治疗方案。
Objective To investigate the pathogenic fungi,clinical types and treatment in children with kerion.Methods The pathogenic fungi,clinical characteristics,treatment and prognosis of children with kerion in the Dermatology Department of Beijing Children′s Hospital from April 2011 to August 2021 were analyzed retrospectively.Results Among the 148 patients with kerion,there were 38 cases of solitary anthracoid abscess,38 cases of small abscesses fused into large areas,41 cases of follicular pustular erythema and lump,and 31 cases of folliculitis-like lesions.Microsporum canis(M.canis)was the most common pathogenic fungus in 4 types of kerion.The percentage of M.canis was higher in folliculitis-like(70.97%)and folliclar pustular erythema and lump kerion(56.10%),while the percentage of Trichophyton mentagrophyte complex was higher in solitary anthracoid abscess kerion(26.32%).All patients were treated with oral terbinafine combined with anti-inflammatory treatment.According to the different clinical types of kerion,the anti-inflammatory treatment schemes were glucocorticoid(orally or topically)or oral compound glycyrrhizin.After 8 weeks of treatment,the effective rate was 97.97%.Conclusion M.canis is the most common pathogenic fungus in children with kerion.Compared with M.canis,T.mentagrophyte complex is more likely to induce kerion with severe inflammation.Clinical antifungal therapy combined with anti-inflammatory therapy can obtain a better curative effect.The corresponding anti-inflammatory treatment scheme should be formulated according to the different types of kerion.
作者
肖媛媛
周亚彬
晁金京
马琳
XIAO Yuanyuan;ZHOU Yabin;CHAO Jinjing;MA Lin(Department of Dermatology,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China)
出处
《中国皮肤性病学杂志》
CAS
CSCD
北大核心
2022年第9期1032-1038,共7页
The Chinese Journal of Dermatovenereology
基金
北京市医院管理中心儿科学科协同发展中心专项经费(XTZD20180502)
首都卫生发展科研专项项目(首发2020-2-4078)。
关键词
脓癣
治疗
糖皮质激素
犬小孢子菌
须癣毛癣菌复合体
Kerion
Treatment
Glucocorticoid
Microsporum canis
Trichophyton mentagrophyte complex
