摘要
患者男,25岁。因右肩部丘疹、斑块7个月,渗出伴结痂3个月就诊。发病前曾于尼日利亚工作,有蚊虫叮咬史。按皮肤利什曼病给予局部清创并口服甲硝唑、氟康唑治疗2个月无效。皮损组织病理示:表皮萎缩,真皮浅中层弥漫性组织细胞浸润,部分细胞内外见利杜小体,伴浆细胞及嗜酸粒细胞浸润;过碘酸-雪夫染色(PAS)阳性;聚合酶链反应(PCR)分子测序显示为硕大利什曼原虫(Leishmania major),明确皮肤利什曼病诊断。患者采用伊曲康唑联合特比萘芬口服、外用盐酸特比萘芬治疗1个月无效,随后使用葡萄糖酸锑钠治疗,3个月后皮损痊愈。
The patient was a 25-year-old male who presented with papules and plaques on right shoulder for 7 months, with exudation and crusts for 3 months. The patient had once worked in Nigeria and suffered from mosquito bites. He was considered as ＂cutaneous leishmaniasis＂ and treated with metronidazole and fluconazole which didn＇t produce any therapeutic effects. The skin biopsy showed epidermal atrophy, many histocytes diffused in dermis with a lot of Leishman-Donovani bodys in and around them, the result of PAS was positive, and the result of PCR confirmed the pathogen was Leishmania major. After the failure of oral itraconazole and terbinafine for 1 month, glucantime therapy was given, 3 months later, the patient＇s lesions healed with hypertrophic scar.
出处
《实用皮肤病学杂志》
2017年第3期186-188,共3页
Journal of Practical Dermatology
关键词
皮肤利什曼病
抗真菌药物
锑剂
Cutaneous leishmaniasis
Antifungal drugs
Glucantime
