皮肤镜及荧光染色镜检在甲真菌病诊断中的应用比较

Comparison of dermoscopy and fluorescent staining examination for diagnosing fungal onychomycosis

目的比较皮肤镜及荧光染色镜检在甲真菌病诊断的应用,并探讨各临床亚型与皮肤镜模式之间的关系。方法对114例疑似甲真菌病的病例进行回顾性研究,比较皮肤镜与荧光染色镜检的敏感性、特异性,分析皮肤镜模式与不同临床亚型的关系。结果82例(71.93%)荧光染色镜检阳性的病甲被诊断为甲真菌病。当参照真菌培养结果时,皮肤镜检查的敏感度和特异度分别为88.68%和24.59%,荧光染色镜检的敏感度和特异度分别为90.57%和44.26%。确诊病甲中常见的皮肤镜模式及发生率为甲纵纹(81.71%)、远端锯齿状改变(78.05%)和甲下角质堆积(47.56%),此3种模式更易见于远端侧位甲下型(P<0.05)。结论皮肤镜可作为诊断甲真菌病的重要辅助工具。

Objective To compare the application of dermoscopy and fluorescent staining in the diagnosis of onychomycosis.The correlation between the clinical subtypes of onychomycosis with dermoscopic patterns was analyzed.Methods A retrospective study of 114 with clinically suspected patients was conducted.The sensitivity and specificity of these two methods were calculated.The most frequent dermoscopic patterns were identified and their correlations with the clinical subtypes of onychomycosis were analyzed.Results A total of 82 cases(71.93%)were positive by fluorescent staining.When compared to the fungal culturing,sensitivity and specificity of dermoscopy was 88.68% and 24.59%,of fluorescent staining was 90.57%and 44.26%.Dermoscopic patterns of onychomycosis showed the following frequencies:longitudinal striae pattern(81.71%),the spiked pattern(78.05%),subungual hyperkeratosis(47.56%).They were more frequency in distal lateral subungual onychomycosis(P<0.05).Conclusion Dermoscopy may be used as an important diagnostic tool for onychomycosis.