真菌荧光染色法检测健康皮肤和炎症性皮损的真菌定植

Fluorescent staining to identify fungal cloning in the healthy skin and inflammatory lesions

目的:利用荧光染色法检测健康皮肤和炎症性皮损的真菌阳性率及定植数量。方法:门诊收集正常皮肤及银屑病、特应性皮炎、湿疹和玫瑰糠疹患者,采集每位患者和健康对照组皮脂溢出部位(面部、胸部和背部)、干燥部位(双上肢)、潮湿部位(腹股沟、腘窝、肘窝)、头皮及足底部位的皮损皮屑,利用真菌荧光染色试剂快速染色,随机选择30个视野计数真菌(孢子)数量,数据使用R 3.5.3软件进行统计学分析。结果:共收集457例患者和888名健康对照,健康对照头皮和皮脂溢出部位的真菌检出率高分别为95%和96%,足底真菌检出率最低(44.29%)。湿疹组、银屑病组和玫瑰糠疹组皮脂溢出部位的真菌检出率分别为77.05%、66.67%、91.42%高于相应的干燥部位58.93%、47.62%、57.89%。在头皮、皮脂溢出部位、干燥部位,疾病组真菌检出率低于健康组,差异有统计学意义(均P<0.05)。健康组4个部位真菌分布的数量不同且差异有统计学意义(P<0.05)。皮脂溢出部位中,18~44岁年龄组孢子数量最多。结论:健康皮肤不同部位的真菌阳性率和孢子数量不同。特应性皮炎、湿疹、银屑病和玫瑰糠疹的皮损部位真菌数量低于正常对照人群。

Objective:To identify the normal range of fungus cloning in different body site of healthy skin and lesions of inflammatory dermatosis.Methods:The patients with psoriasis,eczema,atopic dermatosis and pityriasis rosea were collected.The fungus in different sites including sebaceous sites(face,chest and back),moist sites(bend of elbow,back of knee and groin),dry sites(volar forearm and palm)and scalp of patients and healthy controls were detected by fluorescence staining,and the number of fungi in 30 microscopic areas were counted and statistically analyzed using R 3.5.3.Results:Four hundred and fifty seven patients and 888 controls were collected.The positivity rate of fungi on the scalp and sebaceous sites of healthy volunteers were 95%and 96%highest,which on the plantar was the lowest(44.29%).The positivity rate of fungi in the sebaceous or oily site of patients with eczema,psoriasis and pityriasis rosea were 77.05%,66.67%and 91.42%,which were higher than that in the dry site(58.93%,47.62%,57.89%).The positivity rate of fungi in the scalp,sebaceous sites,dry sites in the healthy controls were higher than that in the corresponding sites of the patients with inflammatory dermatosis,with significant differences(P s<0.05).There was a signitficant different of the amount of fungi among the sebaceous sites,moist sites,dry sites and scalpe in the healthy controls(P<0.05).The number of spores in the sebum area was the highest in the 18-44 age group.Conclusion:The spores and fungal infection rates in different sites are different.The number of fungal spores in the lesions of the patients with psoriasis,eczema,atopic dermatosis and pityriasis rosea were less than that in healthy controls.