不典型扁平湿疣3例误诊分析

The Analysis of 3 Cases of Misdiagnosed Secondary Special Syphilis Condyloma

目的通过分析3例以不典型扁平湿疣为表现的二期梅毒病例被误诊的原因,以减少或避免临床误诊。方法结合3例详细的临床资料,探讨并分析误诊原因,总结经验教训。结果由于3例患者分别在阴囊、舌系带、腋下部位出现不典型的皮损,且患者隐瞒病史,导致误诊,随后皮损组织病理示:血管周围有较多成熟浆细胞、淋巴细胞浸润,提示进行的梅毒血清学检查得以确诊。结论 对于皮疹形态特殊的患者除在一对一的就诊环境下认真询问病史、仔细观察皮损细微的外观形态外,做必理要的组织病理学检查可为临床诊断或进行其它确诊检查提供有益的诊断方向与检查线索。

Objective To analyze the reasons of 3 cases of secondary special syphilis enndyloma misdiagnosed. Methods Comllined with the detailed material of the 3 eases, this paper diseusses and analyzes the misdiagnosis reasons, summing up experiences. Results Because the atypical skin lesions of 3 eases appear on the scrotum, lingual frenums and armpit, and the patients conceal history, leading to misdiagnosis. The pathologieal examinalion of 3 cases showed thai the epidermis looks like pso,＇iasis, and a lot of mature plasma eell and lymphocyte intihrate in the superficial and deep layer of dermis. Finally, eombined with syphilis serological examination, the 3 cases were diagnosed. Conclusion For tile patients with speeial skin lesions, besides asking fnr medical history in a one-on-one medical environment seriously, and observation the lesions form carefully, it is necessary to do pathological examination, whieh can offer some diagnostie direction or some checking elue to the clinical diagnosis.