挪威疥3例并文献复习

Norway scabies: 3 cases and literature reviews

报告3例挪威疥。3例患者均因全身红斑、丘疹、鳞屑伴瘙痒就诊,曾被误诊为银屑病、剥脱性皮炎或湿疹。3例患者血常规检查均提示嗜酸性粒细胞升高,例1尤为明显。皮损组织病理检查:(例1)表皮角化不全伴角化过度,真皮浅层血管周围散在嗜酸性粒细胞。骨髓检查示骨髓增生活跃,浆细胞及嗜酸性粒细胞增多,外周嗜酸性粒细胞增多。3例患者皮屑经镜检均发现典型疥虫形态,诊断为挪威疥。治疗:予外用林旦乳膏或丁香罗勒软膏,配合更换衣物、消毒等措施,皮疹好转,复查皮屑镜检疥虫均为(-)。

Three cases of Norway scabies are reported. Three patients were all suffered with erythemas, papules, scales companied with pruritus. Patients had been misdiagnosed as psoriasis, exfoliative dermatitis or eczema. Patients, especially the case one, showed an increase in blood eosinophils. Histopathological examination of case one showed epidermal parakeratosis, hyperkeratosis, and scattered perivaseular infiltration of eosinophils in the dermis. Bone marrow biopsy showed active bone marrow hyperplasia, increased plasma cells and eosinophils. The number of eosinophils increased in peripheral blood. Microscopy showed typical scab mites in all 3 patients. A diagnosis of Norway scabies was made. Lesions were improved, and mites were negative following treatments with Linden cream or ocimum oil ointment, frequently ehanzing clothes, and disinfection.