中国多变根毛霉感染性皮肤接合菌病13例回顾性分析

中国真菌学杂志　 2013, Vol. 8 　Issue (1): 30-34.

中国多变根毛霉感染性皮肤接合菌病13例回顾性分析

尚毅¹, 方伟², 廖万清²

1. 北京海军总医院, 北京 100037;
2. 上海长征医院皮肤病与真菌病研究所全军真菌病重点实验室第二军医大学附属长征医院皮肤科, 上海 200003

收稿日期:2012-08-01 出版日期:2013-02-28 发布日期:2013-02-28
通讯作者: 廖万清,E-mail:liaowanqing@sohu.com E-mail:liaowanqing@sohu.com
作者简介:尚毅,男(汉族),本科,主治医师.E-mail:shangyi20070523@163.com.cn;方伟,男(汉族),博士,主治医师.E-mail:weifang081782@gmail.com

Primary cutaneous zygomycosis caused by Rhizomucor variabilis in China：a review of 13 cases

SHANG Yi¹, FANG Wei², LIAO Wan-qing²

1. Navy General Hospital, Beijing 100037;
2. Institute of dermatology and fungal disease, Key Laboratory of the army fungal disease, Department of dermatology, Changzheng Hospital, Shanghai 200003

Received:2012-08-01 Online:2013-02-28 Published:2013-02-28

摘要/Abstract

摘要： 目的总结我国自1991年至今报道的所有多变根毛霉感染所致皮肤接合菌病的临床资料,探讨其流行病学特点、临床特征和治疗。方法文献搜索并回顾分析我国13例多变根毛霉原发性皮肤感染的临床资料。结果 13例皮肤多变根毛霉病,平均发病年龄为34±17(5~65)岁,男6例,女7例,病程5个月~16 a不等,感染报道多集中于长江流域;临床多表现为局部红斑、丘疹和/或结节,可缓慢扩展形成浸润性斑块伴溃疡坏死;发病前有明确皮肤损伤病史6例,无明确诱因7例。皮损多发生于暴露部位,面部10例,上肢3例。所有病例均经真菌学和病理学诊断确诊。治疗主要为两性霉素B和唑类抗真菌药物,其中8例治愈,2例疗效不佳,3例失随访。结论多变根毛霉皮肤接合菌病是一种重要的毁容性感染病,多与皮肤屏障损伤有关,提高对本病的认识有利于开展早期诊断和及时治疗,治疗首选两性霉素B。

关键词: 接合菌病, 多变根毛霉, 皮肤感染

Abstract: Objective To investigate the epidemic and clinical characteristics of primary cutaneous zygomycosis due to Rhizomucor variabilis in China since 1991.Methods Thirteen cases of cutaneous mucormycosis caused by Rhizomucor variabilis were searched from the electrical database, and all the clinical information was collected and evaluated.Results Of the 13 case records, 7 were female while 6 were male.Median age was 34?17 (5-65) year and the course ranged from 5 months to 16 years. Most cases were mainly reported in Yangtze River valley. The major clinical manifestations were local erythema, papula, and/or nodule, which might spread into infiltrating plaque associated with ulceration and necrosis. Six patients had defined mucocutaneous damage histories before the onset. All the lesions primarily occurred in exposure parts of the body (10 in the face and 3 in the upper limb) and all the diagnoses were made by mycological and histopathological examinations.The major treatments were amphotericin B and azole drugs.Eight patients were cured, and two had poor results while three lost follow-up.Conclusions Primary cutaneous zygomycosis due to Rhizomucor variabilis is severe disfiguring disease. Enhancing the understanding of its clinical characterisctics will contribute to the early diagnosis and timely treatment, and amphotericin B should be considered as a preferred choice.

Key words: Zygomycosis, Rhizomucor variabilis, cutaneous infection

中图分类号:

R756.6

尚毅, 方伟, 廖万清. 中国多变根毛霉感染性皮肤接合菌病13例回顾性分析[J]. 中国真菌学杂志, 2013, 8(1): 30-34.

SHANG Yi, FANG Wei, LIAO Wan-qing. Primary cutaneous zygomycosis caused by Rhizomucor variabilis in China：a review of 13 cases[J]. Chinese Journal of Mycology, 2013, 8(1): 30-34.

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