登革热102例皮疹特征分析及鉴别诊断

The Features of Skin Rashes in 102 Patients with Dengue Fever and How to Make a Differential Diagnosis

目的分析2014年广州地区流行时间,登革热患者的皮疹特点及鉴别诊断。方法对2014年8月1日-11月30日广州市第八人民医院皮肤科诊治的102例出疹的登革热患者的临床资料进行回顾性分析。结果 102例患者中,男47例,女55例,平均年龄(30.5±12.1)岁,平均病程(10.1±3.2)d。其中93.14%(95/102)的患者出现发热,T(38.9±0.6)℃。平均出疹时间在发热或不适后(4.9±1.3)d。88.24%(90/102)的患者皮疹主要表现为四肢、前胸、颜面密集分布的针尖大小的红斑或出血点,疹间可见正常皮肤,90.20%(92/102)的皮疹伴有明显瘙痒。皮疹平均消退时间为(3.9±1.4)d。结论本病好发于夏秋季节,多见于中青年人群,皮疹主要为密集分布的针尖大红斑,围绕正常皮肤,并常伴瘙痒,其是登革热皮疹的主要特征,有助于鉴别诊断。

Objective To analyze the characteristics of skin rashes in patients suffering from dengue fever of Guangzhou city and to make a differential diagnosis. Methods From August 1 to November 30,2014,102 patients with dengue fever admission to the department of Dermatology and Venereology of the 8th People＇s Hospital in Guangzhou were obtained. Results The patients showed a male/female ratio of 47：55 with an average age of （30. 5 ± 12. 1 ） years and clinical course of （ 10. 1± 3.2 ） days. And 93.14% （95/102） patients suffered from fever with an average temperature being （38. 9 ± 0.6） ℃. All the patients developed rashes after （4. 9 ± 1.3 ） days of fever onset or discomfort onset,88.24% （90/102） patients showed intensive distribution of erythema or bleeding spots of tip size on the limbs, the chest and the face, and in the sea of red rashes there was normal skin. Moreover,the rashes in 90. 20% （92/102） patients were associated with itching. The average fading time of rashes was （3.9 ± 1.4） days. Conclusion Dengue fever occurred more in the summer and fall season and in the young and middle-aged people. The phenomenon of ＂ islands of white＂ in normal skin surrounded by cluster erythema with itching was the main characteristic in dengue fever and help to make a differential diagnosis.