难辨认癣临床调查及致病菌鉴定

Investigation of the Clinical Features and Pathogenic Fungi in Tinea Incognito

目的探讨难辨认癣的临床特点、致病菌种分布情况。方法收集2016年1月-2017年1月就诊于川北医学院附属医院皮肤科难辨认癣患者的临床资料,采用形态学和分子生物学方法鉴定致病菌种。结果共收集到难辨认癣患者49例(男25例,女24例),平均年龄(29.11±21.89)岁。主要发病部位:面部21例(42.86%)、四肢8例(16.33%)、躯干5例(10.20%)。其中误诊为湿疹22例(44.90%)、神经性皮炎8例(16.33%)、面部皮炎6例(12.24%)。41例(83.67%)患者曾经使用过非抗真菌药物治疗,8例(16.33%)未使用过任何药物治疗。致病菌:须癣毛癣菌23例(46.94%),红色毛癣菌21例(42.86%),犬小孢子菌3例(6.12%),断发毛癣菌2例(4.08%)。结论难辨认癣可发生于各年龄段,无明显性别差异,农村居民多于城镇居民;该病最常见于面部,容易被误诊为皮炎湿疹类疾病;外用糖皮质激素与该疾病有关,与致病菌种类的关系仍需进一步研究;难辨认癣主要致病菌是须癣毛癣菌及红色毛癣菌。

Objective To investigate clinical features and pathogenic fungi of tinea incognito. Methods Clinical cases of tinea incognito were collected in Affiliated Hospital of North Sichuan Medical College from Jan 2016 to Jan 2017. The pathogenic dermatophyte species was detected by morphology analysis and molecular biology technology . ResultsA total of 49 patients including 25 males patients and 24 female patients were enrolled . The average age was (29.11±21.89)years old. The lesions occurred in face(42.86%),limbs(16.33%),truncus(10.20%). Tinea incognito had been misdiagnosed as eczema(44.90%),neurodermatitis(16.33%),facial dermatitis(12.24%)et al. Forty-one patients (83.67%) were used non-antifungal drugs treatment before. Four dermatophyte species were identified,including Trichophyton mentagrophytes (46.94%),followed by Trichophyton rubrum (42.86%),Microsporum cains (6.12%)and Trichophyton tonsurans (4.08%). ConclusionThere was no significant gender and age differences,rural residents more than urban residents. It often occurred in face and was easily misdiagnosed as eczema. Topical corticosteroid contributed to tinea incognito but the relationship between pathogenic dermatophyte and the disease still need further study. The most frequent pathogenic dermatophyte species were Trichophyton mentagrophytes and Trichophyton rubrum.